The incidence rate and determinants of thrombotic occlusion of power injectable peripherally inserted central catheters at the WRHA community intravenous infusion clinics in Winnipeg, Manitoba
Bibliographic record
Abstract
Abstract Power-injectable (PI) peripherally inserted catheters (PICCs) have been used frequently in community settings as they provide a reliable central venous access to infuse intravenous infusates. However, these catheters can occlude. Thrombotic occlusion is the most frequent complication of PICCs. A retrospective cohort study was conducted to investigate the incidence rate and the determinants of PI PICCs at the Winnipeg Regional Health Authority (WRHA) Community IV Program (CIVP) IV Infusion Clinics in Winnipeg, Manitoba. Data was extracted from electronic patient charts housed in Accuro Electronic Medical Record at the WRHA CIVP IV Infusion Clinics. Survival analysis methods were used to analyze data. Cox proportional hazards models were used to assess the association between thrombotic occlusion and certain socio-demographic, clinical, insertion and PI PICC-related characteristics. The incidence rate of thrombotic PI PICC occlusion was 32 per 1,000 person-weeks (95% CI: 25-43). After adjusting for IV antimicrobials, ambulatory drug delivery pump use, the tip location of PI PICCs, and the number of PI PICC lumens, the hazard of thrombotic occlusion for those PI PICCs which received IV vancomycin was 5.8 times greater (95% CI: 2.8-12.3). The hazard of thrombotic occlusion was 5.1 times greater (95 % CI: 2.8-9.1) when multiple-lumen PI PICCs used. To reduce the incidence rate of thrombotic occlusion, single-lumen PI PICCs should be used whenever possible. Heparin lock may be used to lock multiple-lumen PI PICCs and when IV vancomycin is infused. Further research with a greater sample size is needed to validate the findings of this study. Keywords: power injectable peripherally inserted central catheters, peripherally inserted central catheters, thrombotic occlusion, withdrawal occlusion, community-based IV infusion clinic, infusion nursing.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.002 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.002 |
| Science and technology studies | 0.001 | 0.000 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".