SHM Converge Scientific Abstract ePoster Gallery-Can the Michigan Picc-DVT Risk Score Predict Midline-DVT

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The study asked whether the Michigan PICC-DVT Risk Score (MRS), originally developed to predict PICC-related deep vein thrombosis (DVT), could also predict DVT in patients receiving midline catheters.<br /><br />Researchers analyzed 19,334 midline placements from 64 Michigan hospitals between December 2016 and July 2022. Adult patients on general medical or intensive care units were followed until midline removal, death, or 30 days. The main outcome was symptomatic, image-confirmed upper-extremity DVT.<br /><br />Overall, 218 midlines (1.13%) were associated with DVT. Several MRS predictors showed some association with DVT in midline users, including:<br />- another central venous catheter present at insertion,<br />- elevated white blood cell count,<br />- active cancer,<br />- history of venous thromboembolism,<br />- and multiple catheter lumens.<br /><br />However, the score’s overall predictive performance was limited for midlines. The MRS had an AUC of 0.73 when hospital-level random effects were included, but only 0.60 without them, suggesting modest to poor discrimination. The original MRS had an AUC of 0.71.<br /><br />The main conclusion was that the Michigan PICC-DVT Risk Score has low predictive power for midline-associated DVT. The low event rate may partly explain this, but it may also indicate that midline DVT is driven by different patient or device factors than PICC-related DVT. The authors suggest that larger studies are needed to develop a midline-specific risk score.

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David Paje

Meta Tag

Author List David Paje, Elizabeth McLaughlin, Jennifer K. Horowitz, Megan Heath, Scott A. Flanders, Scott Kaatz, Steven J. Bernstein, Vineet Chopra

Category Research

Concept Michigan PICC-DVT Risk Score

Concept Midline Catheter

Concept Upper extremity deep vein thrombosis

Concept Intravascular Device

Concept White Blood Cell Count

Distinguished Non-Finalist

Presenter Organization University of Michigan

Presenting Author David Paje

Track Patient Safety

Keywords

Michigan PICC-DVT Risk Score

midline catheters

deep vein thrombosis

upper-extremity DVT

predictive performance

AUC

risk prediction

venous thromboembolism

catheter-associated thrombosis

hospital study

Michigan PICC-DVT Risk Score

Midline Catheter

Upper extremity deep vein thrombosis

Intravascular Device

White Blood Cell Count