Demographic, clinical and device characteristics for all patients that received peripherally inserted central catheters (stratified by PICC appropriateness)
| Total (n=38 592) | Appropriate placement (n=15 128) | Inappropriate placement (n=23 464) | P value | |
| Demographics | ||||
| Age, median (IQR) | 64 (52.9–74.8) | 64.5 (53.4–75.2) | 63.3 (52.1–74.1) | <0.001 |
| Women, n (%) | 18 809 (48.7%) | 6501 (43.0%) | 12 308 (52.5%) | <0.001 |
| Race, n (%) | ||||
| White | 28 540 (74.0%) | 11 466 (75.8%) | 17 074 (72.8%) | <0.001 |
| Black | 7975 (20.7%) | 2838 (18.8%) | 5137 (21.9%) | <0.001 |
| Unknown | 799 (2.1%) | 280 (1.9%) | 519 (2.2%) | 0.015 |
| Other | 1278 (3.3%) | 544 (3.6%) | 734 (3.1%) | 0.012 |
| Clinical characteristics | ||||
| Charlson Comorbidity Score, median (IQR) | 3 (1–5) | 3 (2–5) | 3 (1–4) | <0.001 |
| Body mass index, median (IQR) | 28.8 (24–35.3) | 28.9 (24–35.6) | 28.7 (24.1–35) | 0.111 |
| Comorbidities, n (%) | ||||
| History of cancer | 8593 (22.3%) | 2669 (17.6%) | 5924 (25.2%) | <0.001 |
| History of COPD | 9540 (24.7%) | 3006 (19.9%) | 6534 (27.8%) | <0.001 |
| History of CHF | 10 001 (25.9%) | 2944 (19.5%) | 7057 (30.1%) | <0.001 |
| History of MI | 5813 (15.1%) | 1786 (11.8%) | 4027 (17.2%) | <0.001 |
| History of arthritis | 2227 (5.8%) | 812 (5.4%) | 1415 (6%) | 0.006 |
| History of DVT | 5244 (13.6%) | 1923 (12.7%) | 3321 (14.2%) | <0.001 |
| History of PE | 2704 (7.0%) | 940 (6.2%) | 1764 (7.5%) | <0.001 |
| History of lung disease | 15 600 (40.4%) | 5048 (33.4%) | 10 552 (45%) | <0.001 |
| History of severe illness | 9962 (25.8%) | 1398 (9.2%) | 8564 (36.5%) | <0.001 |
| History of pneumonia | 10 778 (27.9%) | 3274 (21.6%) | 7504 (32%) | <0.001 |
| History of sepsis | 16 430 (42.6%) | 7263 (48%) | 9167 (39.1%) | <0.001 |
| History of CVA/TIA | 6271 (16.2%) | 2051 (13.6%) | 4220 (18%) | <0.001 |
| History of osteomyelitis | 5329 (13.8%) | 3753 (24.8%) | 1576 (6.7%) | <0.001 |
| History of cellulitis | 7124 (18.5%) | 4467 (29.5%) | 2657 (11.3%) | <0.001 |
| Cerebrovascular disease | 5822 (15.1%) | 1926 (12.7%) | 3896 (16.6%) | <0.001 |
| Dementia | 2945 (7.6%) | 1109 (7.3%) | 1836 (7.8%) | 0.074 |
| Diabetes—complicated | 8427 (21.8%) | 3777 (25%) | 4650 (19.8%) | <0.001 |
| Diabetes—uncomplicated | 7137 (18.5%) | 2641 (17.5%) | 4496 (19.2%) | <0.001 |
| Hypertension | 25 931 (67.2%) | 10 025 (66.3%) | 15 906 (67.8%) | 0.002 |
| Mild liver disease | 2473 (6.4%) | 935 (6.2%) | 1538 (6.6%) | 0.143 |
| Severe CKD | 13 398 (34.7%) | 3935 (26%) | 9463 (40.3%) | <0.001 |
| Peripheral vascular disease | 6079 (15.8%) | 2669 (17.6%) | 3410 (14.5%) | <0.001 |
| Active cancer | 2568 (6.7%) | 513 (3.4%) | 2055 (8.8%) | <0.001 |
| Laboratory values, median (IQR) | ||||
| Haemoglobin | 10.3 (8.8–11.8) | 10.1 (8.6–11.7) | 10.6 (9.2–12) | <0.001 |
| White blood cell count | 9 (6.6–12.3) | 9.5 (6.8–13.3) | 8.3 (6.4–10.9) | 0.377 |
| Platelets (×109 per litre) | 237 (170–322) | 221 (156–302) | 263 (194–352) | <0.001 |
| eGFR | 61 (54–93) | 60 (41–87) | 77 (60–101) | 0.006 |
| International normalised ratio | 1.14 (1.02–1.31) | 1.14 (1.03–1.33) | 1.14 (1.02–1.3) | 0.702 |
| Device characteristics | ||||
| PICC days, median (IQR) | 17 (7–30) | 10 (5–28) | 30 (15–35) | <0.001 |
| Gauge (Fr), median (IQR) | 5 (4–5) | 5 (5–5) | 4 (4–4) | <0.001 |
| Number of lumens, n (%) | ||||
| Single | 19 322 (50.1%) | 15 128 (100%) | 4194 (17.9%) | <0.001 |
| Double | 15 785 (40.9%) | 15 785 (67.3%) | ||
| Triple | 3483 (9.0%) | 3483 (14.8%) | ||
| Quadruple | 2 (0.0%) | 2 (0.0%) | ||
| Dwell time ≤5 days, n (%) | 6860 (17.8%) | 6860 (29.2%) | ||
| PICC in patients with CKD, n (%) | 6084 (15.8%) | 6084 (25.9%) | ||
| Indications for PICCs, n (%) | ||||
| Antibiotics | 20 048 (51.9%) | 12 342 (81.6%) | 7706 (32.8%) | <0.001 |
| Blood transfusion or blood products | 179 (0.5%) | 14 (0.1%) | 165 (0.7%) | <0.001 |
| Chemotherapy | 1270 (3.3%) | 129 (0.9%) | 1141 (4.9%) | <0.001 |
| Difficult access/blood draws | 7844 (20.3%) | 1292 (8.5%) | 6552 (27.9%) | <0.001 |
| Medications requiring central access | 4533 (11.7%) | 731 (4.8%) | 3802 (16.2%) | <0.001 |
| Multiple incompatible fluids | 803 (2.1%) | 26 (0.2%) | 777 (3.3%) | <0.001 |
| Parenteral nutrition | 2691 (7%) | 190 (1.3%) | 2501 (10.7%) | <0.001 |
| Medication requiring central access per hospital policy | 98 (0.3%) | 9 (0.1%) | 89 (0.4%) | <0.001 |
| Unknown | 3598 (9.3%) | 884 (5.8%) | 2714 (11.6%) | <0.001 |
| ICU setting, N (%) | 10 953 (28.4%) | 852 (5.6%) | 10 101 (43%) | <0.002 |
| Operator/Inserter, N (%) | ||||
| Vascular access team | 26 644 (69.0%) | 10 666 (70.5%) | 15 978 (68.1%) | <0.001 |
| Interventional Radiology | 7171 (18.6%) | 2679 (17.7%) | 4492 (19.1%) | <0.001 |
| Site-level characteristics | ||||
| Bed size, median (IQR) | 380 (273–584) | 391 (283–632) | 379 (250–537) | <0.001 |
| Total number of discharges, median (IQR) | 19 591 (12 453–29763) | 19 591 (13 245–29763) | 19 307 (10 873–29763) | <0.001 |
| Teaching hospital, % | 37 367 (96.8%) | 14 471 (95.7%) | 22 896 (97.6%) | <0.001 |
| Non-profit, % | 31 401 (81.4%) | 12 479 (82.5%) | 18 922 (80.6%) | <0.001 |
| For-profit, % | 2381 (6.2%) | 1069 (7.1%) | 1312 (5.6%) | <0.001 |
| Government, % | 3137 (8.1%) | 796 (5.3%) | 2341 (10.0%) | <0.001 |
BMI, body mass index; CHF, congestive heart failure; CKD, chronic kidney disease; CLABSI, central line-associated bloodstream infection; COPD, Chronic Obstructive Pulmonary Disease; CVA/TIA, cerebrovascular accident/transient ischaemic attack; CVC, central venous catheter; DVT, deep vein thrombosis; eGFR, estimated glomerular filtration rate; IBS, irritable bowel syndrome; ICU, intensive care unit; MI, Myocardial Infarction; PE, pulmonary embolism; PICC, peripherally inserted central catheter.