Methods: We reviewed medical records of 250 patients discharged with a PICC between Jan and Sept of 2014. Between Sept and Dec 2014, we interviewed 165 of these patients by phone to assess complications.
Results: Among 250 PICC discharges: 62% were for outpatient antibiotics, 26% for access only. Others (12%) were for chemotherapy, TPN and dobutamine. Out of 250 cases, 47% of patients went home, 53% to a skilled nursing facility (SNF); Only 40% were followed by a specialist, a vascular surgery or infectious diseases.
Among 165 interviewed patients: 40% reported PICC complications and 9% major complications: central line-associated bloodstream infection (CLABSI) and DVT; 63 (38%) denied receiving any education on discharge, and 23 of them were discharged home; 16% denied having labs drawn during treatment, and 92% of them were on antibiotics; 57% of PICCs reportedly remained in place for >week after treatment completion. Major adverse events tended to be more common with delayed PICC removal (p=0.06), more frequent daily PICC use (p=0.08) and home rather than SNF discharge (p=0.06), but these associations did not reach statistical significance.
Conclusion: PICC lines placed in the hospital and continued after discharge carry a risk of complication. Lack of patient education and delayed removal of PICC lines appear to be risk factors for complications. Major complications significantly raise the risk of readmission. Large, multicenter studies are needed for further research and development of intervention to reduce complications and therefore cost of health care.