Prevalence and Factors Associated With Indwelling Non-Utilized (Idle) Central Vascular Access Devices Across All Age Groups

Abstract

A retrospective study was conducted in a large, urban, pediatric/adult hospital to investigate the extent of idle central vascular access devices (CVADs) across all age groups and to identify factors that contribute to an in situ nonutilized CVAD. Patients who were hospitalized for >4 days between January 2015 and December 2019 were included. Implanted ports, tunneled catheters, and umbilical lines were excluded. Idle time was defined as a calendar day in which no intravenous medication was administered. A total of 6054 CVADs (59% nontunneled CVADs, 41% peripherally inserted central catheters [PICCs]; 73% adults, 27% children) were analyzed. Among these, 1263 (21%) had at least 1 idle day, with a median idle time and proportion of 3 days and 25%, respectively. Up to 51% and 64% of lines placed in infants/neonatal intensive care unit had idle time compared with 13% and 12% in adults/medical intensive care units (ICUs). The median idle time for PICCs was longer than that of nontunneled CVADs. CVADs with dwell duration greater than the median (duration for their respective departments) had 5.0 (95% CI, 4.2–5.9) odds of being idle. CVADs in the neonatal ICU had 14.2 (95% CI, 10.8–18.6) odds of having idle time compared with those in the medical ICU. This study found that 1 of every 5 CVADs had at least 1 day of idle time, with one fourth of their total dwell duration idle. CVADs with longer dwell duration, those placed in children, and PICCs were more likely to be idle.