External Validation of the Michigan Risk Score for Predicting Peripherally Inserted Central Catheter-Related Deep Vein Thrombosis: A Multicenter Study in Brazil.
The Michigan Risk Score (MRS) was developed to predict peripherally inserted central catheter (PICC)-related thrombosis. This study aimed to externally validate the MRS in a Brazilian cohort.
Adults hospitalized in 16 Brazilian hospitals who received a PICC were followed until catheter removal, death, or 30 days. The MRS assigned risk points based on 5 clinical variables: presence of another central line, white blood cell count >12 000, multi-lumen PICC, history of deep vein thrombosis (DVT), and active cancer. Mixed-effects logistic regression assessed MRS performance, including calibration and discrimination.
A total of 12 725 PICCs in 11 135 patients (mean age 66.4 ± 19 years; 51% female) were included. Deep vein thrombosis occurred in 129 cases (1.0%). Only the number of PICC lumens and history of venous thromboembolism (VTE) were significantly associated with DVT risk. Compared to risk class I, the odds ratios for risk classes III and IV were 2.83 (95% CI, 1.51-5.3) and 3.01 (95% CI, 1.41-6.41), respectively. The area under the curve was 0.70 for the multivariable model and 0.67 for the MRS classification.
Peripherally inserted central catheter lumens and VTE history were independently associated with DVT risk. Classes III and IV of the MRS had higher event rates than class I.
Adults hospitalized in 16 Brazilian hospitals who received a PICC were followed until catheter removal, death, or 30 days. The MRS assigned risk points based on 5 clinical variables: presence of another central line, white blood cell count >12 000, multi-lumen PICC, history of deep vein thrombosis (DVT), and active cancer. Mixed-effects logistic regression assessed MRS performance, including calibration and discrimination.
A total of 12 725 PICCs in 11 135 patients (mean age 66.4 ± 19 years; 51% female) were included. Deep vein thrombosis occurred in 129 cases (1.0%). Only the number of PICC lumens and history of venous thromboembolism (VTE) were significantly associated with DVT risk. Compared to risk class I, the odds ratios for risk classes III and IV were 2.83 (95% CI, 1.51-5.3) and 3.01 (95% CI, 1.41-6.41), respectively. The area under the curve was 0.70 for the multivariable model and 0.67 for the MRS classification.
Peripherally inserted central catheter lumens and VTE history were independently associated with DVT risk. Classes III and IV of the MRS had higher event rates than class I.
Authors
Rabelo-Silva Rabelo-Silva, Saffi Saffi, Hirakata Hirakata, Ferro Ferro, Lourenço Lourenço, da Silva da Silva, da Luz da Luz, Pupin Pupin, Cechinel Cechinel, de Andrade de Andrade, Silva Silva, de Araújo de Araújo, Do Espírito Santo Do Espírito Santo, da Gama da Gama, Soares Soares, Montenegro Montenegro, de Jesus de Jesus, de Freitas de Freitas, Pedraza Pedraza, Veçossi Veçossi, Gimenez Gimenez, Barbosa Barbosa, Chopra Chopra,
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