The risk of venous thromboembolism associated with midline catheters compared with peripherally inserted central catheters: A systematic review and meta‐analysis

Abstract

Background: Both midline catheters (MCs) and peripherally inserted central catheters (PICCs) can cause venous thromboembolism (VTE), but the prevalence associated with each is controversial.Objective: To compare the risk of VTE between MCs and PICCs with a systematic review and meta-analysis. Methods:The Web of Science Core Collection, PubMed, Scopus, Embase, the Cochrane Library and ProQuest were searched from inception to January 2020. All studies comparing the risk of VTE between MCs and PICCs were included. Selected studies were assessed for methodological quality using the Downs and Black checklist. Two authors independently assessed the literature and extracted the data. Any different opinion was resolved through third-party consensus. Meta-analyses were conducted to generate estimates of VTE risk in patients with MCs versus PICCs, and publication bias was evaluated with RevMan 5.3. Results:A total of 86 studies were identified. Twelve studies were recruited, involving 40,871 patients. The prevalence of VTE with MCs and PICCs was 3.97% (310/7806) and 2.29% (758/33065), respectively. Meta-analysis showed that the prevalence of VTE with MCs was higher than that with PICCs (RR=1.53, 95% CI:1.33-1.76, p < .00001). Subgroup analyses by age showed that the prevalence of VTE with MCs was higher than that with PICCs in the adult group (RR=1.75, 95% CI: 1.38-2.22, p < .00001), and higher than that with PICCs in the other subgroups (RR=1.42, 95% CI: 1.19-1.69, p = .0001). Subgroup analyses by nation showed that the prevalence of VTE with MCs was higher than that with PICCs (RR=1.50, 95% CI: 1.30-1.73, p < .00001) in US subgroup and higher than that with PICCs (RR=2.87, 95% CI: 1.24-6.65, p = .01) in the other nations. The sensitivity analysis shows that the results from this meta-analysis are robust and all studies have no significant publication bias.

The research status of central venous catheterization-associated thrombosis: a bibliometrics analysis

“…In a multicenter prospective study of 477 cancer patients who received a total of 50,841 catheterdays, 9 patients (1.9%) developed symptomatic upper extremity deep vein thrombosis (16). In another study, Lu et al included 86 studies for a meta-analysis and demonstrated that the incidence of PICC-related venous thrombosis was 2.29% (17). In another study by Jones et al, catheter-related deep vein thrombosis occurred in 5.5% of PICC patients (18).…”

Thrombophilia Impact on Treatment Decisions, Subsequent Venous or Arterial Thrombosis and Pregnancy-Related Morbidity: A Retrospective Single-Center Cohort Study

“…Categorization as minor and major provoking risk factors was based on the guidance provided by the International Society on Thrombosis and Haemostasis (ISTH) [ 36 ]. In addition to the ISTH-based criteria, the presence of an intravenous catheter [ 37 ] and May-Thurner syndrome (>70% iliofemoral compression) [ 38 ] were categorized as major risk factors, whereas immobilization > 4 h [ 39 ] and heavy smoking (>20 pack years) [ 40 ] as minor risk factors. VTE in the presence of merely an environmental risk factor (male sex and older age) was categorized as unprovoked thromboembolism.…”

Adherence to Thrombophilia Testing Guidelines and its Influence on Anticoagulation Therapy: A Single-Center Cross-Sectional Study

“…Categorization as minor and major provoking risk factors of VTE was based on criteria provided by the International Society on Thrombosis and Haemostasis (ISTH) [30]. In addition to the ISTH based criteria, the presence of intravenous catheter [31] or May-Thurner syndrome (>70 % iliofemoral compression) [32] were categorized as major risk factors, whereas immobilization >4 h [33] and heavy smoking (>20 pack years) [34] as minor risk factors. VTE in the presence of merely an environmental risk factor (male sex and older age) was categorized as unprovoked thromboembolism.…”