What is the mortality rate for PICC lines?

September 28, 2025 •

4 min read

According to research published in PubMed Central, patients requiring a PICC line have a baseline 30-day mortality rate of over 12%, even without developing a PICC-related infection. This means that to understand what is the mortality rate for PICC lines, one must distinguish between the patient's existing health risks and the specific complications associated with the catheter itself.

Quick Summary

The mortality rate for PICC lines is not a fixed number, but varies based on the patient's severe underlying illness. The risk of death is significantly increased when complications like bloodstream infections occur, though this risk can be mitigated with proper care.

Key Points

No Single Mortality Rate: The mortality rate for patients with PICC lines is not a fixed value, as it is primarily influenced by the patient's severe underlying medical conditions.
Infection Increases Risk: Catheter-related bloodstream infections (CRBSIs) are a serious complication that significantly increases the risk of mortality compared to patients without this infection.
Blood Clots are Common: Thrombosis (blood clots) can occur but are often minor and clinically insignificant, though in rare cases, they can lead to a fatal pulmonary embolism.
Proper Care is Key: Strict adherence to sterile insertion techniques, proper daily care, and monitoring for complications is crucial for mitigating risks associated with PICC lines.
Patient Health is a Major Factor: The mortality figures reflect the patient's pre-existing, serious illnesses, which is the primary reason many of these patients have a high baseline risk of death.
Sepsis is a Threat: A bloodstream infection can lead to sepsis, a potentially life-threatening systemic infection, which explains the increased mortality seen in infected patients.

Understanding PICC Line Mortality in Context

A peripherally inserted central catheter (PICC) is an essential tool for delivering long-term intravenous therapies. However, when evaluating the mortality rate associated with PICC lines, it is crucial to consider the baseline health of the patients receiving them. These individuals are often critically ill, with complex conditions like cancer, advanced infections, or other significant diseases that necessitate this form of long-term vascular access. The mortality figures associated with PICC lines therefore reflect both the patient's original, serious illness and any potential complications from the catheter itself.

Major Complications and Their Impact on Mortality

While PICC lines are generally considered safe, they are not without risks. The most serious complications can significantly elevate a patient's risk of mortality, with infections and blood clots being the most prominent concerns.

Catheter-Related Bloodstream Infections (CRBSIs)

A bloodstream infection is one of the most feared complications of any central line, including a PICC. Bacteria can enter the bloodstream through the catheter insertion site or hubs, leading to a serious systemic infection known as sepsis. Studies show a clear link between these infections and increased mortality.

Impact on Mortality: One study showed that for patients who developed a PICC-line associated bacteremia, the 30-day mortality rate increased to 22.09%, which was significantly higher than the 11.83% mortality rate for a control group of PICC patients without bacteremia.
Causative Organisms: A variety of bacteria can cause these infections, including coagulase-negative staphylococci and Staphylococcus aureus.
Onset of Infection: A study found that 75% of bacteremia cases occurred within 21 days of insertion, emphasizing the critical importance of proper hygiene and monitoring during the initial weeks.

Blood Clots (Thrombosis) and Pulmonary Embolism

Formation of a blood clot, or thrombosis, is another common complication associated with PICC lines. This occurs when the catheter irritates the vein, causing a clot to form along the inside of the vessel wall. While many clots are small and clinically insignificant, some can lead to dangerous consequences.

Risk of Pulmonary Embolism (PE): If a clot breaks free, it can travel through the bloodstream and become lodged in an artery in the lungs, causing a potentially fatal pulmonary embolism. While this is a rare occurrence, it is a known risk.
Risk Factors: The risk of thrombosis is influenced by factors such as catheter size, patient characteristics (e.g., obesity, cancer), and catheter insertion technique.
Frequency: Some estimates suggest that thrombosis occurs in 20% to 40% of cases, though most are not clinically significant enough to cause major symptoms.

Comparing PICC Lines to Other Central Catheters

When evaluating risk, it is useful to compare PICC lines to other types of central venous catheters (CVCs) that provide similar access. A key consideration is that PICCs are inserted peripherally (in the arm), while other CVCs are inserted centrally (e.g., jugular or subclavian vein). This difference affects the risk profile.


Feature	PICC Line	Other Central Venous Catheters (CVCs)
Insertion Site	Arm vein (e.g., brachial or basilic)	Large central vein in the neck or chest
Risk of CRBSI	Generally lower or similar, depending on the study and setting. Some studies show PICC use was associated with a reduced risk of CRBSI compared to non-PICC catheters.	Risk can vary depending on insertion site and patient population.
Risk of Pneumothorax	Extremely low to nonexistent, as the chest cavity is not entered during placement.	A potential, though rare, risk during insertion into the subclavian vein.
Infection Risk Factors	Primarily related to catheter hubs and insertion site hygiene.	Also related to hygiene, but proximity to the neck or chest can introduce additional risks.
Thrombosis Risk Factors	Primarily vein irritation and catheter-to-vein ratio.	Catheter tip placement and patient-specific factors are key concerns.

Reducing the Risks of Complications

Adherence to strict protocols is the most effective way to minimize the risks of PICC line complications and their associated mortality. Healthcare facilities and clinicians use standardized procedures to ensure patient safety.

Aseptic Insertion Technique: Maximum sterile barriers are used during insertion to prevent contamination.
Proper Site Selection: The vein-to-catheter ratio is assessed via ultrasound to reduce the risk of thrombosis.
Daily Catheter Care: Routine flushing, sterile dressing changes, and disinfection of access ports are performed by trained healthcare professionals.
Patient and Family Education: Patients are taught about daily care, signs of complications, and when to seek urgent medical attention.
Daily Assessment of Necessity: The clinical need for the PICC is evaluated daily, and the line is removed promptly when no longer needed.

Conclusion: A Balanced Perspective

In conclusion, attributing a single mortality rate to PICC lines is misleading because the risk is so heavily tied to the patient’s existing medical condition. For a patient with a PICC line, the greatest increase in mortality risk comes from complications like a bloodstream infection leading to sepsis, which can be significantly elevated above the patient's already high baseline risk. However, with vigilant care, strict adherence to best practices, and daily monitoring, the risks can be managed effectively. The decision to place a PICC line is always a careful risk-benefit analysis, considering the severity of the underlying illness and the necessity of long-term intravenous therapy. Understanding these factors is key to interpreting the true impact of PICC lines on patient outcomes.

For more detailed information on catheter-related bloodstream infections and patient safety initiatives, you can consult resources from the Agency for Healthcare Research and Quality (AHRQ): Preventing PICC Complications: Whose Line Is It?.

Frequently Asked Questions

No, having a PICC line itself does not guarantee a high mortality rate. The high rates seen in some studies are due to the fact that PICC lines are used in patients who are already severely ill. The mortality rate is a reflection of the patient's underlying disease, not the device alone.

PICC line infections, known as catheter-related bloodstream infections (CRBSIs), are a serious and potentially life-threatening complication that can lead to sepsis. A study showed that for patients with PICC-related bacteremia, the 30-day mortality rate was 22.09%, significantly higher than the baseline mortality of patients with PICC lines.

The most common and dangerous complication leading to increased mortality is a bloodstream infection, which can progress to sepsis. Other severe, but rarer, complications like pulmonary embolism resulting from a blood clot can also be fatal.

Not always. While blood clots (thrombosis) are relatively common, with some sources reporting rates between 20% and 40%, most are minor and cause no significant clinical issues. The most dangerous outcome is a pulmonary embolism, which is a rare event.

Risks can be significantly reduced through proper procedure and care. This includes using sterile techniques during insertion, disinfecting hubs, performing daily assessments of line necessity, and providing proper education to both clinical staff and patients.

The safety profile can vary depending on the patient and clinical setting. Some studies suggest PICC lines have a lower or similar rate of infection compared to other central venous catheters, and they have a lower risk of certain complications like pneumothorax because of their insertion site.

Yes, absolutely. The patient's underlying illness is the most significant factor impacting their overall mortality rate. A PICC line is simply a tool used to treat those illnesses. The mortality rate seen in PICC patients largely reflects the severity of their pre-existing health issues.