RNMeta-AnalysisNursing open2021

The incidence of asymptomatic thrombosis related to peripherally inserted central catheter in adults: A systematic review and meta-analysis People's.

Pei Chen, Bingqian Zhu, Guangming Wan and 1 others

PMID 33617142

WHAT IT FOUND

Asymptomatic PICC thrombosis was found in 22% of adults, usually in superficial veins within two weeks after insertion.

Poor activity, slower blood flow and left basilic placement were reported risk factors.

Key findings

01The pooled incidence of asymptomatic PICC-related thrombosis in adults was 22%.

02Asymptomatic PICC-related thrombosis was more often superficial than deep, and in studies reporting asymptomatic events it occurred 3 to 11.7 days after placement.

03Included studies reported higher ECOG score, slower blood flow velocity and left basilic vein as risk factors for asymptomatic PICC-related thrombosis.

STILL TO COME

How it was doneWhat they foundWhat it means for RNs

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What it does not show

The review included 10 studies, and the reported incidence varied widely from 2.2% to 58%. Half of the studies were conducted in China, and regions such as Africa or Oceania were not represented, so the results may not generalize there. The frequency of ultrasound screening differed between studies, which could affect the detected incidence. Prospective studies were unclear about whether sample size was adequate and whether data analysis covered the identified sample. The paper describes four studies examining risk factors, but the limitations say only two studies examined risk factors, so the risk-factor evidence is inconsistent and could not be quantitatively pooled. The methods said no language restriction was applied, but non-English papers were excluded.

Declared interests

The authors declare no conflicts of interest. The paper lists Shanghai Jiao Tong University as the funder.

The easy way to misread this

Do not treat the 22% pooled incidence as a fixed patient risk. It came from 10 studies with different ultrasound schedules, ranging from 2.2% to 58%, and the review did not test whether routine screening improves outcomes.

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