Safety and risk factors of PICC insertion in hematologic malignancy patients with thrombocytopenia: a retrospective study

作者：Kun Zhang, Hua Huo, Xiang-ling Wu, Yan Wang, Wenxiu Wu, Xin He, Juan Li, Yan Xia · 发表于：Annals of Hematology · 年份：2025 · DOI：10.1007/s00277-025-06717-z · 被引用次数：3 · 研究领域：Blood transfusion and management、Platelet Disorders and Treatments、Venous Thromboembolism Diagnosis and Management

Hematology patients often have severe thrombocytopenia and coagulation dysfunction. Despite the risk of bleeding, PICC insertion is still needed to reduce chemotherapy-related adverse reactions. Currently, there are no definitive indicators for predicting whether PICC placement increases bleeding risk in these patients. Additionally, large-scale studies on the safety of PICC insertion in hematology-oncology patients with platelet counts ≤ 50 × 10⁹/L and/or coagulation abnormalities are lacking. To evaluate the safety of PICC insertion in hematological oncology patients with a platelet concentration ≤ 50 × 10⁹/L and/or coagulation dysfunction through a large-sample retrospective study and to identify risk factors for bleeding after PICC placement. We retrospectively analyzed 1511 hematological patients with a platelet count ≤ 50 × 10⁹/L who underwent PICC insertion from February 2017 to January 2020, focusing on risk factors for bleeding within 24 h post-insertion. Multivariate analysis identified independent risk factors for bleeding within 24 h after PICC insertion as PT ≥ 13 s, platelet count ≤ 25 × 10⁹/L, and ADL score ≤ 95 points. Based on these three risk factors, patients were divided into low-risk (0-1 risk factors, 1% bleeding rate) and high-risk (≥ 2 risk factors, 7% bleeding rate) groups. When 0-1 risk factors are present, PICC insertion is safe even for patients with low platelet counts. If ≥ 2 risk factors exist, the decision to insert a PICC should consider the p...