October 28, 2020
1 min read
Siddiqui MT, et al. Abstract S1281. Presented at: The American College of Gastroenterology Annual Scientific Meeting (Virtual). Oct. 26-28, 2020.
The authors report no relevant financial disclosures
Patients with inflammatory bowel disease receiving long-term home parenteral nutrition via tunneled catheters had lower rates of DVT than those who used peripherally inserted catheters, according to research presented at the ACG Virtual Annual Scientific Meeting.
In his presentation, Mohamed Tausif Siddiqui, MD, from Cleveland Clinic, said peripherally inserted catheters (PICCs) are the most commonly used devices in parenteral nutrition; however, they are associated with higher risk for DVT in patients with IBD. Because studies that have explored this area have focused on an in-patient population, Siddiqui asked, “What about the long-term intravenous catheters for home parenteral nutrition?”
Researchers conducted a retrospective analysis using data from a clinical management database and electronic medical record to compare the incidence of DVT in patients with IBD on home parenteral nutrition with PICCs vs. tunneled catheters.
Overall, 407 patients who had 744 catheter episodes met the study criteria (tunneled, n = 539 vs. PICCs, n = 205). Patients who used tunneled catheters used them for a longer period (252,662 days) compared with patients who used PICCs (65,115 days).
Across the 744-catheter episodes, patients experienced 33 cases of DVT (4.4%). The DVT rate with PICCs was 5.4% compared with 4.1% with tunneled catheters.
Using data based on catheter days, researchers determined the overall DVT rate was 0.1 per 1,000 catheter days. Patients using PICCs had a DVT rate two times higher than patients using tunneled catheters (0.16 vs. 0.08 per 1,000 catheter days, respectively).
Additionally, investigators performed a weighted analysis to account for the longer duration of use among patients who used tunneled catheters. They found that the DVT risk was higher among PICC use (OR = 3.665; 95% CI, 3.516-3.82).
“Patients with IBD who received parenteral nutrition with a PICC have significantly higher risk of DVTs compared with tunneled catheters,” Siddiqui said. “Tunneled catheters for home parenteral nutrition therapy should be preferred if the duration of parenteral nutrition infusion is greater than 4 to 6 weeks.”