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<p>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.&#xa0;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.&#xa0;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&#xa0;h post-insertion.&#xa0;Multivariate analysis identified independent risk factors for bleeding within 24&#xa0;h after PICC insertion as PT ≥ 13&#xa0;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.&#xa0;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 patient’s clinical symptoms and needs. Blood product intervention does not affect the bleeding rate.</p>

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

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2025年11月8日

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  • Kun Zhang,
  • Hua Huo,
  • Xiang-Ling Wu,
  • Yan Wang,
  • Wang-Juan Wu,
  • Xin He,
  • Juan Li,
  • Xia Yan

摘要

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 patient’s clinical symptoms and needs. Blood product intervention does not affect the bleeding rate.