Assessing the thrombosis risk of peripherally inserted central catheters in cancer patients using Caprini risk assessment model: a prospective cohort study

ObjectivePeripherally inserted central catheters (PICC) are frequently used to deliver medical therapies, but our knowledge regarding PICC-related complications remains incomplete. The objective of this study was to systematically elicit and characterise PICC-related complications as experienced by patients during and after hospitalisation.DesignProspective cohort study.SettingInpatient medical units at four US hospitals in two states.ParticipantsConsecutive sample of patients who had a new PICC placed during a hospital stay between August 2015 and May 2017.Main outcome(s)Patient-reported signs and symptoms of a possible PICC-related complication or functional issues.ResultsOf the 438 patients in the analytic cohort (91.4% of those consented), two-thirds were male with a mean age of 56 years. The most common reason for PICC placement was long-term antibiotic therapy (43.4%). During the 70-day follow-up period, 61.4% of patients reported signs of at least one complication, including potentially serious complications, such as bloodstream infection (17.6%) and deep vein thrombosis (30.6%). Correspondence of these reported events with medical record documentation of the complication was generally low. More than one-quarter (27.9%) of patients reported minor complications, such as insertion site redness, discomfort or difficult removal. While the PICC was in place, 26.0% reported restrictions in activities of daily living, 14.4% social activity restrictions and 19.2% had difficulty with flushing or operating the PICC.ConclusionOver 60% of patients report signs or symptoms of a possible complication or adverse effect after PICC placement. Bothersome complications from the patient perspective are clearly more common than those that typically rise to the level of healthcare provider attention or concern. Understanding the patient experience is critical for providing safe and effective care.

Download Full-text

ECG Guided Tip Positioning Technique for Peripherally Inserted Central Catheters in a teaching Hospital: Feasibility and Cost-effectiveness Analysis in a Prospective Cohort Study.

European Journal of Vascular and Endovascular Surgery ◽

10.1016/j.ejvs.2019.06.1221 ◽

2019 ◽

Vol 58 (6) ◽

pp. e531

Author(s):

Arthur Bloemen ◽

Anne Daniels ◽

Roel Janssen ◽

Martine Samyn ◽

Jan-Willem Elshof

Keyword(s):

Cohort Study ◽

Cost Effectiveness ◽

Prospective Cohort Study ◽

Teaching Hospital ◽

Prospective Cohort ◽

Cost Effectiveness Analysis ◽

Peripherally Inserted Central Catheters ◽

Effectiveness Analysis ◽

Positioning Technique ◽

Central Catheters

Download Full-text

Complications with peripherally inserted central catheters (PICCs) used in hospitalized patients and outpatients: a prospective cohort study

Antimicrobial Resistance and Infection Control ◽

10.1186/s13756-016-0161-0 ◽

2017 ◽

Vol 6 (1) ◽

Cited By ~ 36

Author(s):

Delphine Grau ◽

Béatrice Clarivet ◽

Anne Lotthé ◽

Sébastien Bommart ◽

Sylvie Parer

Keyword(s):

Cohort Study ◽

Prospective Cohort Study ◽

Prospective Cohort ◽

Hospitalized Patients ◽

Peripherally Inserted Central Catheters ◽

Central Catheters

Download Full-text

Prospective Cohort Study of Breast Cancer Patients Treated With Radiotherapy

Case Medical Research ◽

10.31525/ct1-nct04203849 ◽

2019 ◽

Author(s):

Keyword(s):

Breast Cancer ◽

Cohort Study ◽

Cancer Patients ◽

Prospective Cohort Study ◽

Prospective Cohort ◽

Breast Cancer Patients

Download Full-text

Inter-observer reliability of a risk assessment model for venous thromboembolism in acutely-ill medical hospitalized patients: Results from a prospective cohort study

Phlebology The Journal of Venous Disease ◽

10.1177/02683555211021226 ◽

2021 ◽

pp. 026835552110212

Author(s):

Cassia RL Ferreira ◽

Marcos de Bastos ◽

Mirella L Diniz ◽

Renan A Mancini ◽

Yan S Raposo ◽

...

Keyword(s):

Risk Factors ◽

Cohort Study ◽

Venous Thromboembolism ◽

Prospective Cohort Study ◽

Prospective Cohort ◽

Risk Classification ◽

Assessment Model ◽

Kappa Statistics ◽

Medical Patients ◽

Observer Reliability

Objectives To analyze the inter-observer reliability of risk for venous thromboembolism (VTE) in a population of adult acutely-ill medical patients. Methods In this prospective cohort study, we collected risk factors and risk classification for VTE using RAM IMPROVE7. Kappa statistics was used to evaluate inter-observer reliability between lead clinicians and trained researchers. We evaluated occurrence of VTE in patients with mismatched classification. Results We included 2,380 patients, median age 70 years (interquartile range [IQR], 58-79), 56.2% female. Adjusted Kappa for VTE risk factors ranged from substantial (0.64, 95% confidence interval [CI], 0.61-0.67) for “immobilization”, to almost perfect (0.98; 95% CI 0.97-0.99) for “thrombophilia”; risk classification was 0.64 (95% CI 0.60-0.67). Divergent risk classification occurred in 434 patients (18.2%) of whom seven (1.6%) developed VTE. Conclusion Despite substantial to almost perfect reliability between observers for risk factors and risk classification, lead clinicians tended to underestimate the risk for VTE.

Download Full-text

5-Hydroxyvitamin D concentration in paediatric cancer patients from Scotland: a prospective cohort study

British Journal Of Nutrition ◽

10.1017/s0007114516004074 ◽

2016 ◽

Vol 116 (11) ◽

pp. 1926-1934 ◽

Cited By ~ 3

Author(s):

Raquel Revuelta Iniesta ◽

Ilenia Paciarotti ◽

Isobel Davidson ◽

Jane M. McKenzie ◽

Celia Brand ◽

...

Keyword(s):

Cohort Study ◽

Relative Risk ◽

Cancer Patients ◽

Prospective Cohort Study ◽

Prospective Cohort ◽

Vitamin D Supplementation ◽

Healthy Children ◽

Paediatric Cancer ◽

Hydroxyvitamin D ◽

Nutritional Data

AbstractChildren with cancer are potentially at a high risk of plasma 25-hydroxyvitamin D (25(OH)D) inadequacy, and despite UK vitamin D supplementation guidelines their implementation remains inconsistent. Thus, we aimed to investigate 25(OH)D concentration and factors contributing to 25(OH)D inadequacy in paediatric cancer patients. A prospective cohort study of Scottish children aged <18 years diagnosed with, and treated for, cancer (patients) between August 2010 and January 2014 was performed, with control data from Scottish healthy children (controls). Clinical and nutritional data were collected at defined periods up to 24 months. 25(OH)D status was defined by the Royal College of Paediatrics and Child Health as inadequacy (<50 nmol/l: deficiency (<25 nmol/l), insufficiency (25–50 nmol/l)), sufficiency (51–75 nmol/l) and optimal (>75 nmol/l). In all, eighty-two patients (median age 3·9, interquartile ranges (IQR) 1·9–8·8; 56 % males) and thirty-five controls (median age 6·2, IQR 4·8–9·1; 49 % males) were recruited. 25(OH)D inadequacy was highly prevalent in the controls (63 %; 22/35) and in the patients (64 %; 42/65) at both baseline and during treatment (33–50 %). Non-supplemented children had the highest prevalence of 25(OH)D inadequacy at every stage with 25(OH)D median ranging from 32·0 (IQR 21·0–46·5) to 45·0 (28·0–64·5) nmol/l. Older age at baseline (R −0·46; P<0·001), overnutrition (BMI≥85th centile) at 3 months (P=0·005; relative risk=3·1) and not being supplemented at 6 months (P=0·04; relative risk=4·3) may have contributed to lower plasma 25(OH)D. Paediatric cancer patients are not at a higher risk of 25(OH)D inadequacy than healthy children at diagnosis; however, prevalence of 25(OH)D inadequacy is still high and non-supplemented children have a higher risk. Appropriate monitoring and therapeutic supplementation should be implemented.

Download Full-text