PICC (Peripherally-Inserted Central Catheters) Lines and Risk of Deep Venous Thrombosis

Background:  PICCs are popular, and avoid risks of central lines, but have their own risk including UExt DVT and PE.
48 Michigan facilities, hospitalized patients between 1/2011 and 3/2014.
n = 76,242 patients, 3790 had PICCs during hospitalization
876 thromboembolic events occurred in 774 patients
PICC associated with excess risk for UExt DVT, LExt DVT and PE.
After adjustment for other risks (recent hospitalization, cancer dx, hx of DVT/PE, etc), PICC use had HR 10.49 for UExt DVT, HR 1.48 for LExt DVT but not for PE.
Conclusion:  PICCs are not harmless.  Uncertain why they are associated with LExt risk, possible confounding?
Am J Med 2015 Sep; 128:986
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