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Phlebitis and infection in peripheral IV devices: A multivariate analysis of clinical trial data
Conference presentation

Phlebitis and infection in peripheral IV devices: A multivariate analysis of clinical trial data

Marianne Wallis
USC Research Conference, 2013 (Sunshine Coast, Australia, 01-Jul-2013–05-Jul-2013)
University of the Sunshine Coast
2013
url
https://www.usc.edu.au/View
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Abstract

Clinical Sciences peripheral intravenous catheters phlebitis
Background: Peripheral intravenous catheters (PIVCs) are inserted in over 80% of all hospital patients and are associated with complications including phlebitis, local infection and catheter related bloodstream infection (CRBSI) that range from uncomfortable to life-threatening. Methods: This secondary analysis of data from a randomised controlled trial of PIVC dwell time used the Prentice, Williams, and Peterson statistical model (conditional risk Cox model) to identify risk factors for phlebitis. Results: In total, data related to 5907 catheters inserted in 3283 patients were analysed. Phlebitis was associated with 7% of patients. No patients developed local infections and one patient developed CRBSI. The risk factors associated with increased incidence of phlebitis included: female gender (HR = 1.64, 95% CI = 1.28 to 2.09), larger diameter PIVC (HR = 1.48, 95% CI = 1.08 to 2.03) and current infection (HR = 1.41, 95% CI = 1.05 to1.89). Age (HR = 0.99, 95% CI = 0.98-0.99) and infusion of "other drugs" (HR = 0.72, 95% CI = 0.56-0.92) reduced risk. The patient with CRBSI was a 60+ year old male surgical patient who had four catheters inserted and was randomised to the third daily change group. The infecting organism Enterobacter cloacae was found on catheter tip and blood culture. Conclusion: PIVC-related phlebitis was associated with fi ve risk factors; only one of which was modifi able (selecting appropriate catheter size). Future research could target the mechanisms underpinning female susceptibility to phlebitis, the effect of IV services versus up-skilling of a majority of staff, and knowledge translation. CRBSI is a complex, multifactorial issue and this case study reinforces the importance of regular monitoring of PIVC sites and early removal of any catheter with signs of phlebitis or occlusion.

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