Risk factors for peripheral venous catheter failure: A prospective cohort study of 5345 patients

Abstract

Purpose: The objective of this study was to determine the independent risk factors associated with peripheral venous catheter (PVC) failure and develop a model that can predict PVC failure. Methods: This prospective, multicenter cohort study was carried out in nine tertiary hospitals in Suzhou, China between December 2017 and February 2018. Adult patients undergoing first-time insertion of a PVC were observed from catheter insertion to removal. Logistic regression was used to identify the independent risk factors predicting PVC failure. Results: This study included 5345 patients. The PVC failure rate was 54.05% ( n = 2889/5345), and the most common causes of PVC failure were phlebitis (16.3%) and infiltration/extravasation (13.8%). On multivariate analysis, age (45–59 years: OR, 1.295; 95% CI, 1.074–1.561; 60–74 years: OR, 1.375; 95% CI, 1.143–1.654; ⩾75 years: OR, 1.676; 95% CI, 1.355–2.073); department (surgery OR, 1.229; 95% CI, 1.062–1.423; emergency internal/surgical ward OR, 1.451; 95% CI, 1.082–1.945); history of venous puncture in the last week (OR, 1.298, 95% CI 1.130–1.491); insertion site, number of puncture attempts, irritant fluid infusion, daily infusion time, daily infusion volume, and type of sealing liquid were independent predictors of PVC failure. Receiver operating characteristic curve analysis indicated that a logistic regression model constructed using these variables had moderate accuracy for the prediction of PVC failure (area under the curve, 0.781). The Hosmer-Lemeshow goodness of fit test demonstrated that the model was correctly specified (χ2 = 2.514, p = 0.961). Conclusion: This study should raise awareness among healthcare providers of the risk factors for PVC failure. We recommend that healthcare providers use vascular access device selection tools to select a clinically appropriate device and for the timely detection of complications, and have a list of drugs classified as irritants or vesicants so they can monitor patients receiving fluid infusions containing these drugs more frequently.

Risk factors for peripheral intravascular catheter-related phlebitis in critically ill patients: analysis of 3429 catheters from 23 Japanese intensive care units

“…However, the most common factors that increased the incidence of phlebitis were drugs, such as nicardipine, noradrenaline, amiodarone, and levetiracetam. Some findings of this study pertaining to critically ill patients were similar to the findings of studies in a general hospital ward setting [10][11][12][19][20][21][22][23][24][25][26][27][28][29][30]. Previous studies related to general wards showed the increased risk of phlebitis with the administration of nicardipine and noradrenaline [12,[31][32][33].…”

Relationship between indwelling site and peripheral venous catheter‐related complications in adult hospitalized patients: A systematic review and meta‐analysis

“…A total of 24 studies (encompassing 16562 PVCs) were included (Arias‐Fernández et al, 2017; Carr et al, 2018; Cicolini et al, 2009; Cicolini et al, 2014; Furtado and d. R. 2011; Lee et al 2019; Lee et al 2009; Marsh et al, 2018; Simin et al, 2019; Singh, Bhandary, & Pun, 2008; Urbanetto et al, 2017; Uslusoy, & Mete, 2008; Wei et al, 2019; Zhu, Wang, & Wen, 2016; do Rego Furtado L.C. 2011; Erdogan, & Denat, 2016; Kaur et al, 2011; Saini et al, 2011; Chen et al, 2021; Fernández‐García, Mata‐Peón, & Avanzas‐Fernández, 2017; Göransson, & Johansson, 2012; Liu et al, 2020; Loureiro et al 2016; Lulie et al, 2021). The pooled results showed that the heterogeneity among the studies was high ( I 2 = 60%).…”

“…A total of 24 studies (encompassing 16562 PVCs) were included (Arias-Fernández et al, 2017;Carr et al, 2018;Cicolini et al, 2009;Cicolini et al, 2014;Furtado and Erdogan, & Denat, 2016;Kaur et al, 2011;Saini et al, 2011;Chen et al, 2021;Fernández-García, Mata-Peón, & Avanzas-Fernández, 2017;Göransson, & Johansson, 2012;Liu et al, 2020;Loureiro et al 2016;Lulie et al, 2021). The pooled results showed that the heterogeneity among the studies was high (I 2 = 60%).…”

Peripheral Venous Puncture and Contrast in Radiological Exams: Social Representations Anchored in Neuman’s Stressors

“…Local adverse reactions originating from several factors may alter, eventually or circumstantially, a person's venous network, their health conditions and clinical management of puncture sites where intravascular catheters (IVC) are used in the infusions [3][4][5][6][7][8] . Therefore, these are events that influence people's health care and experiences.…”