Assessing the influence of risk factors on rates and dynamics of peripheral vein phlebitis: An observational cohort study

Gabriel Mestre Roca, Cristina Berbel Bertolo, Purificación Tortajada Lopez, Gema Gallemi Samaranch, Mari Carmen Aguilar Ramirez, Joan Caylà Buqueras, Jesús Rodríguez-Baño, José Antonio Martinez

Research output: Contribution to journalArticle

Abstract

Background and objectives: To assess the influence of risk factors on the rates and kinetics of peripheral vein phlebitis (PVP) development and its theoretical influence in absolute PVP reduction after catheter replacement. Methods: All peripheral short intravenous catheters inserted during one month were included (1201 catheters and 967 patients). PVP risk factors were assessed by a Cox proportional hazard model. Cumulative probability, conditional failure of PVP and theoretical estimation of the benefit from replacement at different intervals were performed. Results: Female gender, catheter insertion at the emergency or medical-surgical wards, forearm site, amoxicillin-clavulamate or aminoglycosides were independent predictors of PVP with hazard ratios (95 confidence interval) of 1.46 (1.09-2.15), 1.94 (1.01-3.73), 2.51 (1.29-4.88), 1.93 (1.20-3.01), 2.15 (1.45-3.20) and 2.10 (1.01-4.63), respectively. Maximum phlebitis incidence was reached sooner in patients with ≥2 risk factors (days 3-4) than in those with <2 (days 4-5). Conditional failure increased from 0.08 phlebitis/one catheter-day for devices with ≤1 risk factors to 0.26 for those with ≥3. The greatest benefit of routine catheter exchange was obtained by replacement every 60 h. However, this benefit differed according to the number of risk factors: 24.8% reduction with ≥3, 13.1% with 2, and 9.2% with ≤1. Conclusions: PVP dynamics is highly influenced by identifiable risk factors which may be used to refine the strategy of catheter management. Routine replacement every 72 h seems to be strictly necessary only in high-risk catheters.

Original languageEnglish (US)
Pages (from-to)185-191
Number of pages7
JournalMedicina clinica
Volume139
Issue number5
DOIs
StatePublished - Jul 21 2012

Keywords

  • Catheterization
  • Infusions
  • Intravenous/*adverse effects/instrumentation
  • Peripheral/*adverse effects/instrumentation
  • Proportional hazards models
  • Risk factors
  • Thrombophlebitis/*etiology

ASJC Scopus subject areas

  • Medicine(all)

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  • Cite this

    Mestre Roca, G., Berbel Bertolo, C., Tortajada Lopez, P., Gallemi Samaranch, G., Aguilar Ramirez, M. C., Caylà Buqueras, J., Rodríguez-Baño, J., & Martinez, J. A. (2012). Assessing the influence of risk factors on rates and dynamics of peripheral vein phlebitis: An observational cohort study. Medicina clinica, 139(5), 185-191. https://doi.org/10.1016/j.medcli.2011.12.021