Evidence map›Paper›PMID 34226216›Full record

ArticleBMJ open2021

Catheter to vein ratio and risk of peripherally inserted central catheter (PICC)-associated thrombosis according to diagnostic group: a retrospective cohort study.

Rebecca Sharp, Peter Carr, Jessie Childs, Andrew Scullion, Mark Young, Tanya Flynn, Carolyn Kirker, Gavin Jackson, Adrian Esterman

Open access · goldAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in BMJ open, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 35 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
35citing papers in PubMed, 2 pooled it
11.7field-weighted citation impact, top 1% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

35 citing papers in PubMed, 2 syntheses or guidelines pooled it, 53 citations in OpenAlex.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors at 7 institutions in 3 countries.

Rebecca SharpClinical and Health Sciences/Rosemary Bryant AO Research Centre, University of South Australia, Adelaide, South Australia, Australia Rebecca.Sharp@unisa.edu.au.ORCID 0000-0003-3334-2990
Peter CarrSchool of Nursing and Midwifery, National University of Ireland Galway, Galway, Ireland.
Jessie ChildsClinical & Health Sciences, University of South Australia, Adelaide, South Australia, Australia.
Andrew ScullionVascular Access Team, Calvary Mater Hospital, Newcastle, New South Wales, Australia.
Mark YoungPeri-Operative Services, St Vincent's Hospital Sydney, Sydney, New South Wales, Australia.
Tanya FlynnCancer Services, St George Hospital, Sydney, New South Wales, Australia.
Carolyn KirkerDepartment of Anaesthesia and Pain Management, Capital and Coast District Health Board, Wellington, New Zealand.
Gavin JacksonMedical Imaging, Fiona Stanley Hospital, Perth, Western Australia, Australia.
Adrian EstermanClinical and Health Sciences/Rosemary Bryant AO Research Centre, University of South Australia, Adelaide, South Australia, Australia.
University of South Australia · AUCalvary Mater Newcastle Hospital · AUCapital and Coast District Health Board · NZFiona Stanley Hospital · AUGriffith University · AUSt George Hospital · AUSt Vincent's Hospital Sydney · AU

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectivesDetermine the effect of the catheter to vein ratio (CVR) on rates of symptomatic thrombosis in individuals with a peripherally inserted central catheter (PICC) and identify the optimal CVR cut-off point according to diagnostic group.

designRetrospective cohort study.

setting4 tertiary hospitals in Australia and New Zealand.

participantsAdults who had undergone PICC insertion. PRIMARY OUTCOME MEASURE: Symptomatic thrombus of the limb in which the PICC was inserted.

results2438 PICC insertions were included with 39 cases of thrombosis (1.6%; 95% CI 1.14% to 2.19%). Receiver operator characteristic analysis was unable to be performed to determine the optimal CVR overall or according to diagnosis. The association between risk of thrombosis and CVR cut-offs commonly used in clinical practice were analysed. A 45% cut-off (≤45% versus ≥46%) was predictive of thrombosis, with those with a higher ratio having more than twice the risk (relative risk 2.30; 95% CI 1.202 to 4.383; p=0.01). This pattern continued when only those with malignancy were included in the analysis, those with cancer had twice the risk of thrombosis with a CVR greater than 45%. Whereas the 33% CVR cut-off was not associated with statistically significant results overall or in those with malignancy. Neither the 33% or 45% CVR cut-off produced statistically significant results in those with infection or other non-malignant conditions.

conclusionsAdherence to CVR cut-offs are an important component of PICC insertion clinical decision making to reduce the risk of thrombosis. These results suggest that in individuals with cancer, the use of a CVR ≤45% should be considered to minimise risk of thrombosis. Further research is needed to determine the risk of thrombosis according to malignancy type and the optimal CVR for those with a non-malignant diagnosis.

Indexed as

Catheterization, Central VenousCatheterization, PeripheralUpper Extremity Deep Vein ThrombosisAdultAustraliaCathetersHumansNew ZealandRetrospective StudiesRisk Factorsadult oncologyinterventional radiologyradiology & imaging

Identifiers

PMID34226216
PMCPMC8258560
OpenAlexW3180527862

What OpenQuestion holds

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LicenceCC BY-NC
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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.