Peripherally Inserted Central Catheter Statistics: What the Numbers Show
Peripherally inserted central catheter statistics tell a very practical story: PICCs are common, but they are not low-effort devices. They are used at scale, carry meaningful complication risk, and their outcomes vary sharply by age, setting, lumen count, and catheter size.
Table of Contents
- Fast facts
- How PICCs are used
- Complication patterns
- Pediatric statistics
- Adult and hospital statistics
- What device design changes
- Practical reading of the data
Fast Facts
- More than 2.7 million PICC insertions are performed yearly in the United States (Be Picky about your PICCs—Fragmented Care and Poor).
- PICCs are inserted through a peripheral arm vein and terminate in the superior vena cava or right atrium (Be Picky about your PICCs—Fragmented Care and Poor).
- CDC catheter types guidance places PICCs in arm veins such as the basilic, cephalic, or brachial veins and notes lengths of 20 cm or longer depending on patient size (CDC catheter types table).
- CDC characterizes PICCs as having a lower infection rate than nontunneled central venous catheters (CDC catheter types table).
- A recent systematic review and meta-analysis associated PICCs with a 29% complication rate (Effectiveness and Safety of Methods to Prevent Bloodstream and Other Infections and Noninfectious Complications Associated With PICCs).
How PICCs Are Used
PICCs sit between a peripheral IV and a more invasive central line in terms of placement and maintenance burden. That middle position is one reason the statistics matter: the device is familiar, widely used, and often chosen because it seems operationally efficient, yet the outcomes show a substantial amount of downstream management.
The volume alone is notable. More than 2.7 million insertions each year in the United States (Be Picky about your PICCs—Fragmented Care and Poor) means small differences in complication rates can affect a very large number of patients. When a device is used at that scale, even a modest change in infection risk, occlusion risk, or removal rate becomes clinically relevant.
Placement location also helps explain why PICCs are so often selected. They are inserted through arm veins and advanced until the tip sits centrally in the superior vena cava or right atrium (Be Picky about your PICCs—Fragmented Care and Poor). That structure gives them the reach of a central device while avoiding some of the insertion steps associated with other central catheters. CDC catheter types guidance also lists common arm-vein access points such as the basilic, cephalic, and brachial veins (CDC catheter types table).
Complication Patterns
The headline number from the meta-analysis is straightforward: PICCs were associated with a 29% complication rate (Effectiveness and Safety of Methods to Prevent Bloodstream and Other Infections and Noninfectious Complications Associated With PICCs). That figure is not a single outcome type. It is a broad signal that complications are routine enough to shape practice, not just rare exceptions. The same review included 17 adult studies, 1 pediatric study, and 24 neonatal studies (Effectiveness and Safety of Methods to Prevent Bloodstream and Other Infections and Noninfectious Complications Associated With PICCs), which matters because the pooled total is built from heterogeneous settings.
A useful way to read the evidence is to separate frequency from severity. Some complications are mechanical, some are infectious, and some are thrombotic. Several studies in the statistics set show that the dominant failure mode is not the same in every population, which means prevention strategies have to be tailored instead of generic.
Common complication signals across studies
| Study context | Key statistic | Source label |
|---|---|---|
| Pediatric antimicrobial cohort | 207 complications across 10,712 catheter days in 610 PICCs | Frequency of PICC Complications in Children |
| Pediatric antimicrobial cohort | 19.3 complications per 1,000 PICC days | Frequency of PICC Complications in Children |
| Mixed inpatient/outpatient cohort | Overall complication rate of 30.2% | Complications with PICCs used in hospitalized patients and outpatients |
| Mixed inpatient/outpatient cohort | 11.1 complications per 1,000 PICC days | Complications with PICCs used in hospitalized patients and outpatients |
| Cancer outpatient/inpatient cohort | 4.1 complications per 1,000 catheter days | PICC in outpatient and inpatient oncological treatment |
| Adult hospitalized cohort | 31 infections among 923 PICCs | Peripherally Inserted Central Catheter-Related Infections in a Cohort of Hospitalized Adult Patients |
Those numbers are not interchangeable. A per-1,000-day rate measures exposure over time, while a percentage measures what happened to a cohort of devices or patients. Using both together gives a better picture of how risk appears in practice.
In the adult hospitalized cohort, 31 PICC-related infections occurred among 923 PICCs, equal to 3.4% of PICCs and 1.64 per 1,000 catheter days (Peripherally Inserted Central Catheter-Related Infections in a Cohort of Hospitalized Adult Patients). CR-BSI accounted for 27 of those 31 infections, or 87.1% (Peripherally Inserted Central Catheter-Related Infections in a Cohort of Hospitalized Adult Patients), showing that bloodstream infection dominated the infection picture in that dataset.
Fast read on complication types
- Occlusion is a recurring issue in children and adults.
- Infection risk persists across settings, but the balance of local infection, bloodstream infection, and line removal differs by cohort.
- Thrombotic outcomes become more visible as catheter size increases and in some ICU and oncology settings.
- Removal or replacement is often the practical endpoint, even when the first event is another complication.
Pediatric Statistics
The pediatric data in this set is especially detailed, and it shows how quickly PICC risk can accumulate in children. In immunocompetent children receiving antimicrobials, 610 PICCs produced 207 complications during 10,712 catheter days (Frequency of PICC Complications in Children). That works out to 19.3 complications per 1,000 PICC days (Frequency of PICC Complications in Children).
The distribution of complications is important. Of the 610 PICCs, 171 had at least one complication (Frequency of PICC Complications in Children). Another 22 PICCs had 2 complications each, and 7 PICCs had 3 complications each (Frequency of PICC Complications in Children). That means a subset of devices contributed repeated events rather than a single isolated issue.
The timing data adds another layer. The median day of first pediatric complication was 7 days, with an interquartile range of 3 to 15 days (Frequency of PICC Complications in Children). PICC-associated infections appeared later than mechanical or thrombotic complications, at 19 days versus 6 days (Frequency of PICC Complications in Children). That gap suggests early surveillance may need to focus on mechanical and thrombotic concerns first, while infection risk stays relevant later in the dwell period.
Pediatric complication breakdown
| Pediatric measure | Value | Source label |
|---|---|---|
| Total PICCs studied | 610 | Frequency of PICC Complications in Children |
| Total complications | 207 | Frequency of PICC Complications in Children |
| Catheter days | 10,712 | Frequency of PICC Complications in Children |
| Complications per 1,000 PICC days | 19.3 | Frequency of PICC Complications in Children |
| PICCs with at least one complication | 171 | Frequency of PICC Complications in Children |
| PICCs with 2 complications | 22 | Frequency of PICC Complications in Children |
| PICCs with 3 complications | 7 | Frequency of PICC Complications in Children |
| Median day of first complication | 7 days | Frequency of PICC Complications in Children |
| Infection onset vs mechanical or thrombotic onset | 19 days vs 6 days | Frequency of PICC Complications in Children |
| Events occurring after discharge | 77 of 207, or 38% | Frequency of PICC Complications in Children |
Occlusion was the single most common pediatric complication, with 71 events and 34.3% of complications (Frequency of PICC Complications in Children). More than half of those occlusions, 52.1%, required TPA (Frequency of PICC Complications in Children), while 4.2% required catheter replacement and 5.6% required catheter removal (Frequency of PICC Complications in Children). That combination matters because occlusion is often treated as a maintenance issue until it creates enough friction to alter the course of care.
In the same pediatric cohort, 19 children had PICC-related infections requiring antibiotic change or PICC removal, equal to 9.1% of complications and 3% of the total cohort (Frequency of PICC Complications in Children). A further 64 of 207 children, or 31.0%, required PICC replacement or removal (Frequency of PICC Complications in Children). So even when the immediate event was not infection, a large share of children still ended up with a device-level endpoint.
Age also changed the picture. Infants under 1 year had 30.7 complications per 1,000 PICC days, children age 1 to 4 years had 27.3, children age 5 to 10 years had 11.6, and children older than 10 years had 8.5 (Frequency of PICC Complications in Children). That gradient is hard to ignore. It shows that younger children carried a much higher complication burden than older children in that dataset.
Pediatric risk-factor signals
- Non-central tip PICCs represented 16.1% of inserted catheters in one pediatric risk-factor study (Risk Factors for PICC Complications in Children).
- Those non-central-tip PICCs were more than 3 times as likely to be removed for a complication (Risk Factors for PICC Complications in Children).
- Pediatric PICC complication rates at one institution fell from 17.2 per 1,000 catheter days in 2003 to 5.5 per 1,000 in 2009 (Risk Factors for PICC Complications in Children).
- Another pediatric review reported complication rates ranging from 1.11 to 19.3 per 1,000 catheter days (A review of PICCs in very small children and pediatric patients).
Adult and Hospital Statistics
Adult data in the set shows a similar pattern: the device can be useful, but complications are not rare. In hospitalized adults, 923 PICCs were placed in 644 unique patients (Peripherally Inserted Central Catheter-Related Infections in a Cohort of Hospitalized Adult Patients). Thirty-one adult PICC-related infections occurred, equal to 3.4% of PICCs (Peripherally Inserted Central Catheter-Related Infections in a Cohort of Hospitalized Adult Patients). The infection rate was 1.64 per 1,000 catheter days (Peripherally Inserted Central Catheter-Related Infections in a Cohort of Hospitalized Adult Patients).
The adult study also identified factors that increased infection odds. Chemotherapy was associated with higher PICC infection odds, with OR 7.2 (Peripherally Inserted Central Catheter-Related Infections in a Cohort of Hospitalized Adult Patients). Auto/allograft therapy was associated with OR 5.9 (Peripherally Inserted Central Catheter-Related Infections in a Cohort of Hospitalized Adult Patients). Anticoagulant therapy was associated with OR 2.2 (Peripherally Inserted Central Catheter-Related Infections in a Cohort of Hospitalized Adult Patients). Those are strong signals that the clinical context around the line matters, not just the line itself.
The mixed inpatient/outpatient cohort paints a similar picture with a different mix of endpoints. Overall complication rate was 30.2% and 11.1 complications per 1,000 PICC days (Complications with PICCs used in hospitalized patients and outpatients). Hospitalized patients had a 36.1% complication rate and 14.38 complications per 1,000 PICC days, while outpatients had a 19.4% complication rate and 3.19 per 1,000 PICC days (Complications with PICCs used in hospitalized patients and outpatients). That gap suggests inpatient use is associated with a heavier complication burden in that cohort.
Mixed cohort breakdown
| Cohort | Complication rate | Per 1,000 PICC days | Source label |
|---|---|---|---|
| Overall | 30.2% | 11.1 | Complications with PICCs used in hospitalized patients and outpatients |
| Hospitalized patients | 36.1% | 14.38 | Complications with PICCs used in hospitalized patients and outpatients |
| Outpatients | 19.4% | 3.19 | Complications with PICCs used in hospitalized patients and outpatients |
In that same cohort, occlusion occurred in 8.9% of PICCs and accidental withdrawal also occurred in 8.9% (Complications with PICCs used in hospitalized patients and outpatients). Infections occurred in 6.3% of PICCs, including 4.7% local infections and 1.6% bloodstream infections (Complications with PICCs used in hospitalized patients and outpatients). Venous thrombosis occurred in 1.6% and hematoma in 1.0% (Complications with PICCs used in hospitalized patients and outpatients).
Cancer-specific data also shows how the setting affects the balance of risk. In an outpatient/inpatient oncological cohort, the overall complication rate was 4.1 per 1,000 catheter days (PICC in outpatient and inpatient oncological treatment). Local insertion-site inflammation occurred in 4.4% of PICCs, venous thrombosis in 2.9%, bloodstream infection in 2.1%, and occlusion in 2.1% (PICC in outpatient and inpatient oncological treatment). Major adverse events were reported in 2.7% of patients, mostly due to PICC-associated bloodstream infection (PICC in outpatient and inpatient oncological treatment).
What Device Design Changes
Several of the statistics point to line design and line size as major levers. In the ICU study across 52 hospitals, 6,268 PICCs were placed by vascular access nurses and 933 by interventional radiology among ICU PICCs (PICCs in the ICU: A Retrospective Study of Adult Medical Patients in 52 Hospitals). Vascular access nurses placed 75.7% of ICU PICCs, and interventional radiology placed 11.3% (PICCs in the ICU: A Retrospective Study of Adult Medical Patients in 52 Hospitals). The study also found that 87% of hospitals reported a median PICC dwell time of 14 days or less (PICCs in the ICU: A Retrospective Study of Adult Medical Patients in 52 Hospitals).
Single-lumen use was low in many ICU sites. Median single-lumen use across ICU PICC sites was 4.2%, with an interquartile range of 2.0% to 8.0% (PICCs in the ICU: A Retrospective Study of Adult Medical Patients in 52 Hospitals). That ranged from 0% to 100% across sites (PICCs in the ICU: A Retrospective Study of Adult Medical Patients in 52 Hospitals), which signals major practice variation. The same study found that larger-gauge PICCs had a 21.6% composite complication rate versus 13.5% for smaller-gauge PICCs (PICCs in the ICU: A Retrospective Study of Adult Medical Patients in 52 Hospitals). Larger-gauge lines also had 5.4% VTE versus 3.1% for smaller-gauge lines, and 15.9% catheter occlusion versus 10.6% for smaller-gauge lines (PICCs in the ICU: A Retrospective Study of Adult Medical Patients in 52 Hospitals).
A separate diameter-focused analysis showed the same pattern. Symptomatic DVT rose from 0.89% with 3 Fr PICCs to 10.66% with 6 Fr PICCs in a meta-analysis (Symptomatic DVT Associated With PICCs of Different Diameters). In oncology patients, symptomatic DVT was 4.13% with 4 Fr, 8.06% with 5 Fr, and 11.11% with 6 Fr PICCs (Symptomatic DVT Associated With PICCs of Different Diameters). The direction is consistent: larger diameter is associated with higher thrombosis risk in these datasets.
Lumen count and CLABSI signals
- In one CLABSI analysis, PICC CLABSI rates increased from 0.57 with single-lumen lines to 1.20 with triple-lumen lines (Examining CLABSI rates by central-line type).
- In the same analysis, CVC CLABSI rates increased from 0.91 with single-lumen lines to 2.63 with triple-lumen lines (Examining CLABSI rates by central-line type).
That pattern is useful because it suggests line complexity matters across central-line types, not only PICCs. It also reinforces the idea that the smallest effective configuration is often the safer one when clinical needs allow it.
Practical Reading of the Data
The most useful takeaway from these peripherally inserted central catheter statistics is not that PICCs are good or bad. It is that risk is structured. The device is common, its complications are measurable, and the pattern changes by population and configuration.
A few themes stand out from the data alone:
- PICCs are widely used, so even moderate complication rates create a large system-level burden (Be Picky about your PICCs—Fragmented Care and Poor).
- Children, especially infants and younger age groups, show higher complication rates than older pediatric patients in the studies here (Frequency of PICC Complications in Children).
- Occlusion is a common operational problem, not a rare edge case, and it can lead to TPA use, replacement, or removal (Frequency of PICC Complications in Children).
- Infection risk is persistent but does not appear uniformly across settings; inpatient, oncology, and adult hospital cohorts each show distinct profiles (Complications with PICCs used in hospitalized patients and outpatients; PICC in outpatient and inpatient oncological treatment; Peripherally Inserted Central Catheter-Related Infections in a Cohort of Hospitalized Adult Patients).
- Larger-gauge and multi-lumen designs are repeatedly associated with worse complication signals in the ICU and diameter studies (PICCs in the ICU: A Retrospective Study of Adult Medical Patients in 52 Hospitals; Symptomatic DVT Associated With PICCs of Different Diameters; Examining CLABSI rates by central-line type).
For readers comparing PICC use across services, the most actionable interpretation is to treat the line as a risk-bearing device whose outcome profile depends on size, lumen count, patient age, and care setting. The statistics do not support a one-size-fits-all expectation. They support careful selection and follow-through, because the line itself is only one part of the result.