Complications after peripherally inserted central catheter versus central venous catheter implantation in intensive care unit: propensity score analysis using a nationwide database

ABSTRACT

Background

It remains unclear whether peripherally inserted central catheters (PICCs) are superior to central venous catheters (CVCs); therefore, we compared post-implantation complications between CVC and PICC groups.

Research design and methods

Patients who received CVCs or PICCs between April 2010 and March 2018 were identified from the Diagnosis Procedure Combination database, a national inpatient database in Japan. The outcomes of interest included catheter infection, pulmonary embolism, deep vein thrombosis, and phlebitis. Propensity score overlap weighting was used to balance patient backgrounds. Outcomes were compared using logistic regression analyses.

Results

We identified 164,185 eligible patients, including 161,605 (98.4%) and 2,580 (1.6%) in the CVC and PICC groups, respectively. The PICC group was more likely to have overall complications (odds ratio [OR], 1.70; 95% confidence interval [CI], 1.32–2.19), pulmonary embolism (OR, 2.32; 95% CI, 1.38–3.89), deep vein thrombosis (OR, 1.86; 95% CI, 1.16–2.99), and phlebitis (OR, 1.72; 95% CI, 1.27–2.32) than the CVC group. There was no significant intergroup difference in catheter infection (OR, 1.09; 95% CI, 0.39–3.04).

Conclusions

Patients with PICCs had a significantly greater incidence of complications than did those with CVCs. Further research is necessary to explore the factors contributing to these complications.

KEYWORDS:

• Central venous catheter
• propensity score
• Japan
• pulmonary embolism
• phlebitis
• catheterization

Abbreviations

PICC, peripherally inserted central catheter; CVC, central venous catheter; ICD-10, International Classification of Diseases, 10th revision; OR, odds ratio; CI, confidence interval

Declaration of interest

The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.

Reviewers disclosure

Peer reviewers on this manuscript have no relevant financial relationships or otherwise to disclose.

Declaration of generative AI in scientific writing

This study did not use generative AI in scientific writing.

Data availability statement

The datasets analyzed in this study are not publicly available owing to contract with the hospitals.

Geolocation information

Data for this study were collected on a Japan-wide cross-sectional basis. Data analysis was conducted at the Hongo Campus of The University of Tokyo Graduate School of Medicine.

Additional information

Funding

This work was supported by the Ministry of Health, Labor, and Welfare, Japan under Grant 23AA2007 and 22AA2003; and JSPS KAKENHI under Grant 23K16486.