Infection Rate of Hickman Catheters Versus Peripherally Inserted Central Venous Catheters in Oncology Patients

Full Article

WY Wong, WCS Chan, SK Ip, WK Ng, CX Chan, HM Ho, KL Siu, CB Tan

Hong Kong J Radiol 2015;18:197-204

DOI: 10.12809/hkjr1514289

Objective: To compare the incidence of catheter-related infection in the bloodstream and non-infectious complication rate of Hickman catheter and peripherally inserted central venous catheter (PICC) in oncology patients.

Methods: A retrospective study was performed of oncology patients who underwent Hickman catheter or PICC placement at the radiology department of a regional hospital in Hong Kong from January 2008 to December 2013. The catheter-related bloodstream infection rate, time to infection onset, and non-infectious complication rate of the Hickman group and PICC group were evaluated and compared.

Results: During the study period, 161 Hickman catheters and 29 PICCs were inserted in oncology patients (n = 190). There were 38 cases of catheter-related bloodstream infection in the Hickman group and four cases in the PICC group. The catheter-related bloodstream infection rate for all catheters, Hickman group, and PICC group was 1.364, 1.340 and 1.654 per 1000-catheter-days, respectively. For non-infectious complications, 15 of 161 Hickman cases had complications (6 catheter blockage, 5 leakage, 4 migration and dislodgement). In the PICC group, 6 of 29 had complications (3 blockage, and 3 migration and dislodgement). There was, however, no statistically significant difference between the Hickman and PICC groups in terms of number of infections (p = 0.241), time to infection onset (p = 0.187), non-infectious complication rate (p = 0.101), and overall complication rate (p = 0.766).

Conclusion: With the less invasive nature of PICC insertion, it provides a viable means of vascular access for oncology patients.