Incidence, risk factors and medical cost of peripheral intravenous catheter-related complications in hospitalised adult patients

Abstract

Background: Peripheral intravenous catheters (PVCs) are widely used vascular access devices for infusion therapy; however, they are associated with relatively high failure rates. This study aimed to identify the incidence, risk factors and medical costs of PVC-induced complications in adult hospitalised adult patients in China. Methods: An observational, prospective study on 1069 patients lasting 5 months was conducted at a tertiary teaching hospital. Results: Infiltration ranked first among PVC complications with an incidence of 17.8%, followed by occlusion (10.8%) and phlebitis (10.5%). Most complications in phlebitis (88.4%) and infiltration (93.7%) were Grade 1. Catheters left in for over 96 h did not show a higher incidence of complications. Patients from the surgical department were more susceptible to infiltration, phlebitis and occlusion. The 26 gauge (Ga) catheters decreased the risk of phlebitis and occlusion, whereas 24Ga catheters increased infiltration rates. Infusing irritant drugs increased phlebitis and infiltration rates. The presence of comorbidities and non-use of needleless connectors were associated with occlusion. Compared with forearm insertion, the risk of occlusion nearly doubled with the dorsum of the hand insertion and the risk of infiltration tripled with antecubital fossa insertion. Medical treatment costs for PVC complications ranged from 0.3 to 140.0 CNY. Conclusions: Infiltration is the most common PVC-related adverse event. Clinically-indicated instead of routine replacement of catheters is safe. More efforts are warranted to improve nurses’ adherence to recent guidelines in terms of insertion site selection and needleless connector utilisation to reduce medical costs associated with catheter replacement.

Incidence and Associated Factors of Failed First Peripheral Intravenous Catheters among Adult Patients at Medical Surgical Wards in Public Referral Hospitals of West Amhara, Ethiopia, 2021

“…However, in the present study peripheral catheters left in for over 96 hours did not show a higher incidence of complications. This finding was in line with a study's findings in China and King Abdulaziz Medical City, Riyadh, Saudi Arabia where duration for PIVCs insertion was not a significant predictor of the complications [ 10 ]. This was in agreement with the notion that routine replacement of PIVCs does not affect on the incidence of catheter failures [ 24 ] and the catheter for adult patients should be changed when clinically indicated only [ 16 ].…”

“…e current study indicated that the majority of the complications were grade −1 in both phlebitis and infiltration. is finding is in line with the study finding in China where most of the complications in phlebitis (88.4%) and infiltration (93.7%) were grade −1 (10). It is also supported by a study conducted in Japan where 72.6% of phlebitis was Grade −1 [14].…”

“…However, the procedure is not free of risks as it puts the patient susceptible to local and systemic complications [ 4 , 8 ]. It has unacceptably high failure rates [ 9 , 10 ], and the failure rate lies between 35% and 50% [ 5 ]. PIVCs usually fail prematurely before the end of the treatment because of complications [ 11 ].…”

Cost-effectiveness analysis of bundled innovative devices versus standard approach in the prevention of unscheduled peripheral venous catheters removal due to complications in France

“…We therefore estimated them on the basis of series of observations in our hospital. Average costs to handle one episode of diffusion (€4.09 vs [€0.12-€19.41]), occlusion (€3.67 vs [€0.25-€14.03]) and phlebitis (€12.27 vs [€0.04-€14.49]) were in the range of values reported in China [ 21 ].…”

Long-Term Follow-Up and Clinical Relevance of Incidental Findings of Fibrin Sheath and Thrombosis on Computed Tomography Scans of Cancer Patients with Port Catheters

“…Numerous complications associated with the use of central venous catheters (CVCs) have been described in literature, including infections, leakage, and catheter-related thrombosis (CRT). 1,2 Besides morbidity and mortality resulting from the catheter-associated complication itself, catheter dysfunction may necessitate treatment interruption, negatively affecting the treatment outcome. 3 Different studies showed that complete or partial catheter occlusion affects 16-58% of patients after two years of CVC placement.…”