Incidence of and risk factors for local complications of peripheral venous catheters in patients older than 70 years: Empirical research quantitative

医学 导管 入射(几何) 外科 观察研究 前瞻性队列研究 并发症 中心静脉导管 血肿 经皮 蜂窝织炎 内科学 物理 光学
作者
Emmanuelle Gras,Alexia Jean,Vincent Rocher,Yohann Tran,Sandrine Katsahian,Diane Jouclas,Catherine Dano,Johane Cedile,Dalinda Manar,Najiby Kassis Chikhani,J. Le Guen,Clémence Patas D’illiers,David Lebeaux
出处
期刊:Journal of Clinical Nursing [Wiley]
卷期号:32 (15-16): 5000-5009 被引量:4
标识
DOI:10.1111/jocn.16732
摘要

Abstract Aims To assess the incidence density of local complications of peripheral venous catheters in patients aged 70 years and older, to identify risk factors for local complications of peripheral venous catheters, to describe microbiological epidemiology and to assess the impact of complications on patient outcomes. Design Prospective, observational, single‐centre study. Methods Patients 70 years and older admitted to the geriatric department of a teaching hospital in France between December 2019 and May 2020 were considered for inclusion if they had a peripheral venous catheter during their stay. Nurses checked the catheter insertion site three times a day for local complications; physicians ensured the follow‐up of complications. The STROBE checklist was used in this prospective observational study. Results A total of 322 patients were included, with 849 peripheral venous catheters; the median age was 88 years and 182 (56.5%) were women. The incidence density of local complications was 50.5/1000 peripheral venous catheter‐days. Risk factors for local complications on multivariate analysis were dressing replacement (OR 1.18), furosemide (OR 1.11) and vancomycin (OR 1.60) infusion, urinary continence (OR 1.09) and hematoma at the catheter insertion site (OR 1.15). Thirteen cellulitis and three abscesses were diagnosed. Occurrence of a local complication was associated with a 3‐day increased duration of hospital stay (17 vs. 14 days). Conclusion Risk factors for peripheral venous catheter local complications include urinary continence, furosemide or vancomycin infusion, hematoma at the peripheral venous catheter insertion site or dressing replacement. Implication for the Patient Care Closer clinical monitoring may help reduce the occurrence of local peripheral venous catheters complication in patients 70 years and older. Relevance to Clinical Practice Patients at greater risk of peripheral venous catheter local complications deserve closer clinical monitoring or improved preventive measures, which may be beneficial to reduce the length of hospital stay. No Patient or Public Contribution The study was designed to describe risk factors for local complications of peripheral venous catheters in order to reinforce surveillance in this specific population by nurses and medical staffs. Patients had their peripheral venous catheter insertion site checked thrice a day by the nurse in charge as part of usual care. They, as service users, caregivers or members of the public, were not solicited for data collection, analysis, interpretation or preparation of the manuscript.
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