Predictive Value of Red Cell Distribution Width in the Diagnosis of Peripherally Inserted Central Catheter (Picc)-Related Thrombosis among Cancer Patients

Purpose: This study aimed to investigate the predictive value of red cell distribution width (RDW) in patients with peripherally inserted central catheter (PICC)-related thrombosis.Patients and methods: This was a case-control study. A total of 98 cancer patients undergoing PICC placement from January 2017 to December 2019 at the ICU Venous Access Center of Peking University Cancer Hospital were retrospectively analyzed. These included 47 cases in the thrombosis group and 51 cases in the nonthrombosis group according to the occurrence of PICC-related thrombosis within 90 days after the PICC procedure.Results: a) RDW was significantly higher in the thrombosis group (15.98 +/- 1.93) than in the nonthrombosis group (13.98 +/- 1.09). Additionally, the number of smoking histories in the thrombosis group (18, 38.30%) was significantly higher than that in the nonthrombosis group (5, 9.80%). b) Logistic regression analysis indicated that RDW and smoking history were independent risk factors for PICC-related thrombosis (OR: 3.028, P<0.001; OR: 5.640, P=0.023). c) The area under the receiver operating characteristic (ROC) curve of the combination of RDW and smoking history was 86.8%, and the sensitivity and specificity for predicting thrombosis after PICC were 85.1% and 80%, respectively. d) Cox regression analysis revealed that RDW and smoking history were independent risk factors for PICC-related thrombosis (p<0.001). e) Results from Kaplan-Meier analysis showed that incidence of PICC-related thrombosis in patients with RDW less than 14.75% is significantly lower than those with RDW 14.75% and above (p<0.001). e) Baseline RDW was not different between the two groups (P>0.05), Delta RDW was significantly different between the two groups (p<0.001).Conclusion: The combined use of RDW and smoking history has early evaluation and predictive value in the diagnosis of PICC-related thrombosis.