Risk Factors For Phlebitis Research Articles

Trailblazing exploration: Unraveling phlebitis and its enigmas in children

The present study was aimed to assess the incidence of phlebitis and identify the factors that cause phlebitis in children with a peripheral intravenous cannula.A prospective observational study was conducted between 15 July 2022 to 30 November 2022 in pediatrics wards of a tertiary care hospital. 225 children with PIVC were included in the study. PIVC was observed till phlebitis developed or maximum for seven consecutive days after enrollment. Phlebitis was defined by using the Jackson VIP scale. The incidence of phlebitis was 54.22% at 95% confidence interval. There was a significant association between phlebitis and the use of crystalloids, frequency of PIVC handling per day, use of cancer drugs, and use of a three-way, method of drug administration. The mean life span of PIVC was 69.86 ±32.88 hours, and the range was 19-180 hours.The incidence of phlebitis is much higher than the acceptable limit as per Infusion Therapy Standards of Practice which should be reduced. Crystalloids, the Method of drug administration, and cancer drugs are the risk factor for phlebitis. The study suggests that most likely phlebitis occurs after three days.

Knowledge Regarding Risk Factors of Phlebitis and its Association with Education Among Nurses at Tertiary Care Hospital, Karachi

Phlebitis is the inflammation of a vein, typically in the legs, due to a blood clot or other causes. Risk factors for developing phlebitis include prolonged immobility, age, family history, obesity, smoking, and certain medical conditions, such as cancer, heart disease, and inflammatory bowel disease, which can increase the risk of phlebitis. Objective: To assess the knowledge regarding risk factors of phlebitis and its association with nurses’ education among nurses at a tertiary care Hospital in Karachi. Methods: This cross-sectional analytical study was conducted at a tertiary care hospital in Karachi from September to December 2022. A total of 53 nurses were part of the study, and a convenient sampling technique was used to approach the participants. The data were collected through a valid and reliable tool. Results: Study results show that Among 53 participants, the male participant 26(49.1%), whereas the female participant was 27 (50.9%). Study results also found that 17.0% of nurses have High-level knowledge, whereas 83.0% of the participants have moderate, level knowledge about the risk factors of phlebitis. Moreover, the study found no significant difference between the knowledge score and the nurses' education p-value of 0.794. Conclusions: These findings suggest that nurses may need further education and training regarding the risk factors of phlebitis, as most nurses have only a moderate level of knowledge. Investigating other factors impacting nurses’ knowledge may also be essential, such as work experience and training programs.

A study of the risk factors for phlebitis in patients stratified using the acute physiology and chronic health evaluation II score and admitted to the intensive care unit: A post hoc analysis of the AMOR-VENUS study.

Peripheral intravascular catheters (PIVCs) are inserted in most patients admitted to the intensive care unit (ICU). Previous research has discussed various risk factors for phlebitis, which is one of the complications of PIVCs. However, previous studies have not investigated the risk factors based on the patient's severity of illness, such as the Acute Physiology and Chronic Health Evaluation (APACHE) II score. Different treatments can be used based on the relationship of risk factors to the illness severity to avoid phlebitis. Therefore, in this study, we investigate whether the risk factors for phlebitis vary depending on the APACHE II score. This study was a post hoc analysis of the AMOR-VENUS study involving 23 ICUs in Japan. We included patients with age ≥ 18 years and consecutive admissions to the ICU with PIVCs inserted during ICU admission. The primary outcome was phlebitis, and the objective was the identification of the risk factors evaluated by hazard ratio (HR) and 95% confidence interval (CI). The cut-off value of the APACHE II score was set as ≤15 (group 1), 16-25 (group 2), and ≥26 (group 3). Multivariable marginal Cox regression analysis was performed for each group using the presumed risk factors. A total of 1,251 patients and 3,267 PIVCs were analyzed. Multivariable marginal Cox regression analysis reveals that there were statistically significant differences among the following variables evaluated HR (95%CI): (i) in group 1, standardized drug administration measures (HR, 0.4 [0.17-0.9]; p = 0.03) and nicardipine administration (HR, 2.25 [1.35-3.75]; p < 0.01); (ii) in group 2, insertion in the upper arm using the forearm as a reference (HR, 0.41 [0.2-0.83]; p = 0.01), specified polyurethane catheter using polyurethane as a reference (HR, 0.56 [0.34-0.92]; p = 0.02), nicardipine (HR, 1.9 [1.16-3.12]; p = 0.01), and noradrenaline administration (HR, 3.0 [1.52-5.88]; p < 0.01); (iii) in group 3, noradrenaline administration (HR, 3.39 [1.14-10.1]; p = 0.03). We found that phlebitis risk factors varied according to illness severity. By considering these different risk factors, different treatments may be provided to avoid phlebitis based on the patient's severity of illness.

Risk factors for peripheral venous catheter-related phlebitis stratified by body mass index in critically ill patients: A post-hoc analysis of the AMOR-VENUS study.

Phlebitis is an important complication in patients with peripheral intravascular catheters (PIVCs). Although an association between body mass index (BMI) and phlebitis has been suggested, the risk of phlebitis according to BMI has not been well elucidated. Therefore, in this study, we analyzed the risk of phlebitis according to BMI in patients in the intensive care unit (ICU). This study undertook a secondary analysis of the data from a prospective multicenter observational study assessing the epidemiology of phlebitis at 23 ICUs in Japan. Patients admitted into the ICU aged ≥18 years with a new PIVC inserted after ICU admission were consecutively enrolled and stratified into the following groups based on BMI: Underweight (BMI < 18.5 kg/m2), normal weight (18.5 ≤ BMI < 25.0 kg/m2), and overweight/obese (BMI ≥ 25.0 kg/m2). The primary outcome was phlebitis. The risk factors for phlebitis in each BMI-based group were investigated using a marginal Cox regression model. In addition, hazard ratios and 95% confidence intervals were calculated. A total of 1,357 patients and 3,425 PIVCs were included in the analysis. The mean BMI for all included patients was 22.8 (standard deviation 4.3) kg/m2. Among the eligible PIVCs, 455; 2,041; and 929 were categorized as underweight, normal weight, and overweight/obese, respectively. In the underweight group, catheter size ≥ 18 G and amiodarone administration were independently associated with the incidence of phlebitis. Drug administration standardization was associated with the reduction of phlebitis. In the normal weight group, elective surgery as a reason for ICU admission, and nicardipine, noradrenaline, and levetiracetam administration were independently associated with the incidence of phlebitis. Heparin administration was associated with the reduction of phlebitis. In the overweight/obese group, the Charlson comorbidity index, catheter size ≥ 18 G, and levetiracetam administration were independently associated with the incidence of phlebitis. Catheters made from PEU-Vialon (polyetherurethane without leachable additives) and tetrafluoroethylene were associated with the reduction of phlebitis. We investigated the risk factors for peripheral phlebitis according to BMI in ICU and observed different risk factors in groups stratified by BMI. For example, in underweight or overweight patients, large size PIVCs could be avoided. Focusing on the various risk factors for phlebitis according to patients' BMIs may aid the prevention of phlebitis.

Phlebitis associated with peripheral venous catheter placement: systematic review

Peripheral venous catheter (PVC) is often a common application we use for patient care worldwide for intravenous (IV) fluid administration. Objective: to examine the scientific literature on phlebitis associated with peripheral venous catheter placement through systematic review. Methodology: it is a literature review for the realization of this process, the recommendations of the PRISMA method will be followed. Main results: the worldwide prevalence of phlebitis was Australia 12%, Portugal 11.5%, Germany 7.6%, Spain 5.6%, Portugal 36.7%. Risk factors: age, venipuncture site, venous catheter size, failed attempts, and HIV drugs, diabetic patients, immunosuppressive drugs, venipuncture site, cathlon number 18. Risk factors for phlebitis: age, sex, venipuncture site, large venous catheters, failed attempts, hypertonic fluids, antibiotics. Conclusion: the staff should know the symptoms of phlebitis, monitor the site where the peripheral venous line was placed, the anatomical part should focus on the caliber of the venous catheter, the care should be comfortable and safe, thus increasing the quality of care and avoiding complications such as inflammation,

A Study to Assess the Occurrence and Risk Factors of Phlebitis among Peripheral Intravenous Cannulated Patients admitted in Emergency Wards of SKIMS, Soura, Srinagar with a view to develop Phlebitis Prevention Protocol

Introduction: Almost half of the patients who are administered intravenous fluid infusion or blood transfusion via IV cannula insertion develop phlebitis. This study was conducted to assess the occurrence and risk factors of phlebitis among peripheral intravenous cannulated patients admitted in the emergency wards of SKIMS, Soura, Srinagar with a view to develop phlebitis prevention protocol. Methodology: A non-experimental descriptive research design was used for the study. Convenient sampling technique was used for the selection of 250 patients. The prepared tool (semi-structured observation checklist) and phlebitis prevention protocol were validated by experts. Pre-testing and pilot study was conducted on patients other than the study sample. The data collected were analysed using descriptive and inferential statistics.Results: The results of our study showed that phlebitis occurred in more than half of the patients (58%). Among these, grade-1 phlebitis was seen in most of the patients (32.8%) and grade 4 phlebitis was seen in only 0.4%. Most of the patients developed phlebitis within the first 48 hours (26.4%) and 72 hours (20.4%) of cannulation time. There was a significant association of phlebitis with age and gender, site of cannulation, disinfection of cannula site, size/ gauge of cannula, infusion of ionotropic drugs and blood and its products, mode of infusion of IV fluids potassium chloride, and phenytoin, administration of piperacillin/ tazobactam, vancomycin, metronidazole, and imipenem. Conclusion: Staff nurses should be made aware of the various risk factors associated with phlebitis. Appropriate training and education programmes should be implemented.

Risk factors for peripheral intravascular catheter-related phlebitis in critically ill patients: analysis of 3429 catheters from 23 Japanese intensive care units

BackgroundPhlebitis is an important complication occurring in patients with peripheral intravascular catheters (PIVCs). The risk factors for phlebitis in the intensive care unit (ICU) was examined.MethodsA secondary analysis of a prospective multicenter cohort study was conducted, involving 23 ICUs in Japan—the AMOR–VENUS study. Consecutive patients aged ≥ 18 years admitted to the ICU with newly inserted PIVCs after ICU admission were enrolled. Characteristics of the ICU, patients, PIVCs, and the drugs administered via PIVCs were recorded. A marginal Cox regression model was used to identify the risk factors associated with phlebitis.ResultsA total of 2741 consecutive patients from 23 ICUs were reviewed for eligibility, resulting in 1359 patients and 3429 PIVCs being included in the analysis population. The median dwell time was 46.2 h (95% confidence interval [CI], 21.3–82.9). Phlebitis occurred in 9.1% (95% CI, 8.2–10.1%) of catheters (3.5 cases/100 catheter days). The multivariate analysis revealed that the only factors that increased the risk of developing phlebitis were drugs administered intravenously. This study included 26 drugs, and 4 were associated with increased phlebitis: nicardipine (HR, 1.85; 95% CI, 1.29–2.66), noradrenaline (HR, 2.42; 95% CI, 1.40–4.20), amiodarone (HR, 3.67; 95% CI, 1.75–7.71) and levetiracetam (HR, 5.65; 95% CI, 2.80–11.4). Alternatively, factors significantly associated with a reduced risk of phlebitis were: standardized drug administration measures in the ICU (HR, 0.35; 95% CI, 0.17–0.76), 30≤ BMI (HR, 0.43; 95% CI, 0.20–0.95), catheter inserted by a doctor as nurse reference (HR, 0.55; 95% CI, 0.32–0.94), and upper arm insertion site as forearm reference (HR, 0.52; 95% CI, 0.32–0.85). The nitroglycerin was associated with a reduced phlebitis risk (HR, 0.22; 95% CI, 0.05–0.92).ConclusionVarious factors are involved in the development of phlebitis caused by PIVCs in critically ill patients, including institutional, patient, catheter, and drug-induced factors, indicating the need for appropriate device selection or models of care in the ICU.Trial registration: UMIN-CTR, the Japanese clinical trial registry (registration number: UMIN000028019, July 1, 2017).

The Risk Factors of Phlebitis in The Installation of Intravent Catalysts

Background: A hospital is a health service facility that allows nosocomial infections, namely phlebitis. Phlebitis is a complication of intravenous catheter placement that is characterized by redness, pain, swelling, and fever. The high rate of phlebitis in various countries is due to the risk factors that predispose to the incidence of phlebitis due to intravenous catheter placement.Objective: This study aims to determine the risk factors for phlebitis in intravenous catheter placement.Methodology: This study uses an observational analytic method with a cohort design. The study was conducted on 27 February - 14 March 2020 with 22 samples taken using purposive accidental sampling in the inward and RST surgery Dr. Soedjono Magelang. The instrument used was an observation sheet designed by researchers that had been tested by experts and a standard operational checklist for infusion. Data analysis uses a chi-square test and multiple logistic regression.Results: The incidence of phlebitis was 7 respondents (31.8%) and the associated risk factors were the type of infusion fluid (RR = 4.37 CI 95% 1.09-17.58; p-value 0.020). While the factors of age, sex, nutritional status, chronic diseases, types of injection drugs, insertion location, duration of installation, nurse skills, installation techniques, and catheter size were not related to the incidence of phlebitis (p-value 0.05).Conclusion: Although several factors are not related to the incidence of phlebitis, these factors can be a support for the incidence of phlebitis.

Analysis of peripherally inserted central catheter-related complications: a retrospective cohort study of 2,974 children with blood diseases in a single center of China.

Although the peripherally inserted central catheter (PICC) has been widely utilized, there is still a lack of large sample size-based relevant risk factor investigation for the children with blood diseases in a single center of China. We performed a retrospective cohort study through including a total of 2,974 cases aged 0-18 years with blood diseases and PICC insertion. Success rates of different PICC operation techniques were compared. Targeting the common PICC-related complications, we performed the univariate and multivariate logistic regression analyses. Then, based on the screened risk factors, the prediction modeling analysis of binary logistic regression was conducted. The "B-ultrasound plus Seldinger technology" showed a higher success rate of PICC placement than the "non-assistive blind insertion". The catheter type was closely linked to the occurrence of catheter occlusion. The age, insertion site, and catheter type might be the risk factors of phlebitis, while the insertion site, operation season, and catheter type might be associated with catheter fracture. Furthermore, based on these risk factors, we established the nomogram prediction models of phlebitis, rash occurrence, and catheter fracture, respectively, which shows a good predictive ability and a moderate level of predictive accuracy. Our findings first shed new light on the preoperative estimation of the risk factors of PICCrelated complications for the children with blood diseases in China.

Risk factors of phlebitis in patients receiving nicardipine hydrochloride as continuous peripheral intravenous infusion: a single-center retrospective observational study

Risk factors of phlebitis in patients receiving nicardipine hydrochloride as continuous peripheral intravenous infusion: a single-center retrospective observational study

Risk factor for phlebitis in a patient with peripheral intravenous catheters: a cohort study

Phlebitis is one of nosocomial infections that frequently occurred in hospitals. Phlebitis is mainly related with infusion and therapy. Many risk factors can cause phlebitis. The purpose of this study was to predict the prevalence of phlebitis in patients based on the causal factors in Banyumas Regional Hospital. The design of this study was an analytic survey of cohort approach, with a sample of 218 by using consecutive sampling. The study was conducted from November to December 2019 using checklist of observation sheets. The results demonstrates 5 phlebitis risk factors associated with the occurrence of phlebitis, namely the type of fluid (P = 0.011), nutritional status (P = 0.001), catheter size (P = 0.002), injection therapy (P = 0.027) and comorbidities (P = 0.003). The probability of 5 risk factors for the occurrence of phlebitis (88.28%) with nutritional status being the dominant factor (b = 3.928) with probability of (13.48%). To minimize the prevalence of phlebitis, the medical personnel may conduct initial phlebitis screening to determine accurate and appropriate preventive measures.

Risk Factors for Phlebitis in Patients with Peripheral Intravenous Catheters

Introduction: The study investigated the risk factors of phlebitis associated with infusion by peripheral intravenous catheter (PIVC).&#x0D; &#x0D; Methodology: Hospitalized adults (n = 506) were placed with PIVCs by trained nurses. Rates of phlebitis were noted according to PIVC gauge, insertion site, and dwell time; and type and volume of infusion solution.&#x0D; &#x0D; Results: The development of phlebitis appeared to be significantly associated with the size of the outer diameter of the PIVC. The rate of phlebitis among patients given a hypertonic infusion solution was significantly higher; and also associated with infusion volume. There was no difference in phlebitis development among insertion sites, and dwell times among these sites were comparable.&#x0D; &#x0D; Conclusion: The risk of phlebitis increased with the PIVC size and volume of infusion solution, and use of a hypertonic solution. The recognition of risk factors and standardized intervention may reduce the occurrence of phlebitis associated with PIVC use.

Use of infrared thermography in the detection of superficial phlebitis in adult intensive care unit patients: A prospective single-center observational study.

Common methods to detect phlebitis may not be sufficient for patients in the intensive care unit (ICU). The goal of this study was to investigate the feasibility of infrared (IR) thermography to objectively detect phlebitis in adult ICU patients. We included a total of 128 adult ICU-patients in a pilot and subsequent validation study. Median [interquartile range] age was 62 [54–71] years and 88 (69%) patients were male. Severity of phlebitis was scored using the visual infusion phlebitis (VIP)-score, ranging from 0 (no phlebitis) to 5 (thrombophlebitis). The temperature difference (ΔT) between the insertion site and a proximal reference point was measured with IR thermography. In 78 (34%) catheters early phlebitis and onset of moderate phlebitis was observed (VIP-score of 1–3). In both the pilot and the validation study groups ΔT was significantly higher when the VIP-score was ≥1 compared to a VIP-score of 0 (p<0.01 and p<0.001, respectively). Multivariate analysis identified ΔT (p<0.001) and peripheral venous catheter (PVC) dwell time (p = 0.001) as significantly associated with phlebitis. IR thermography may be a promising technique to identify phlebitis in the ICU. An increased ΔT as determined with thermography may be a risk factor for phlebitis.

Frequency of Peripheral Intravenous Catheter Related Phlebitis and Related Risk Factors: A Prospective Study

Background: Peripheral Intravenous Catheterization (PIVC) related complication is a common and significant problem in clinical practices. The aim of the study was to see the pattern of complication developed by PIVC and to find out the associated risk factors.&#x0D; Materials &amp; methods: A prospective study was conducted amongst 300 patients and 420 PIVCs were observed.&#x0D; Results: 76 (18.09%) patients developed phlebitis and among the phlebitis patients 55.26% were grade 2 and 22.37% grade 3. Hypertonic fluid infusion and some antibiotics were found as risk factors for phlebitis. Amongst the antibiotics flucloxacilin (60%), amikacin (50%), amoxicillin + clavulanic acid were most common antibiotics responsible for development of phlebitis.&#x0D; Conclusions: Catheterization site and use of antibiotics and potassium chloride with associated co-morbidities are predisposing factors for phlebitis. Better insertion technique may be sought to lower the incidence of PIVC related complications.&#x0D; J MEDICINE JUL 2019; 20 (1) : 29-33

The Effectiveness of Interactive Workshop Concerning Parenteral Methods of Administration of Medication on Nurses Knowledge toward Best Techniques

Background: Injection is routinely administered by nurses in healthcare facilities and in the community. There for, improving the knowledge base for the best practice techniques of injections administration among nurses limit risk of undesirable complications among patients. Aim of the study: The current study tends to assess the effectiveness of interactive workshops concerning parenteral methods of administration of medications on nurses knowledge toward best techniques. Subjects and Methods: A pre-posttest quasi-experimental study was carried out starting from 1\ February \2016 to the 30\ July \ 2016. The subjects consisted of 30 nurses from Al-Hilal Hospital for Health Insurance in Sohag governorate as part of the in-service training program. The number has been changed during the study period to only 27 participants during the follow-up procedure. A questionnaire was used. It had two parts. (The first part): collects the nurses personal data (socio-demographic data part, and (the second part): measures nurses' knowledge of the right techniques of injections along 3 stages: before, immediately after, and during follow-up phase. The questionnaire has 20 MCQs revolving around the best techniques of parenteral administration such as 10 patient rights, injections sites, and side effects, the time and places of heparin injection, the uses of central venous catheter, and the risk factors of phlebitis with its symptoms and preventive procedures of extravasation. The data were analyzed by using the SPSS, version 19. Results: The mean score of nurses knowledge concerning the best techniques of injection in pre-intervention phase was noticeably poor. It improved in posttest phase; and such improvement continued in the follow-up phase in spite of the slight knowledge shortage during this stage. The success of the interactive workshop has been highlighted by higher immediately posttest and follow-up scores (16.3 ±1.4, 10.5 ±2.2) respectively, compared with the scores obtained prior to training on parenteral administration (6.6 ±2.10), with statistical significant differences (p&lt;0.00). The study indicates that the more a nurse is young; the more she is able keep knowledge and information in both the pre-intervention or follow-up phases, with statistical significant differences among group before the application of the program. The study also finds that those who have about 11 years experience and more are less knowledgeable compared to other group. The study also finds that graduates of secondary schools and technical institutes are more able to keep information during the follow-up phase compared to other group of nursing specialists, with statistical significant differences exists among groups in post intervention phase. The study indicates that there is a statistical relation between nurses age, years of experience and levels of acquiring knowledge. Conclusion: The implementation of an interactive workshop concerning the best parenteral methods of administration of medication on nurses knowledge leads to, the improvement of nurses knowledge immediately after the intervention and for 3 months after the workshop. Recommendations: The study recommends that more emphasis should be put continuous on interactive educational in order to provide high quality nursing care. A protocol about the best techniques of injection should be distributed among nurses, with intensive studies in this regard on a large scale of nursing specialists.

CN44 - Incidence and risk factors of phlebitis in patients with peripheral parenteral nutrition administration

CN44 - Incidence and risk factors of phlebitis in patients with peripheral parenteral nutrition administration

Incidence and risk factors of phlebitis in patients with peripheral parenteral nutrition administration

Incidence and risk factors of phlebitis in patients with peripheral parenteral nutrition administration

Phlebitis and infiltration: vascular trauma associated with the peripheral venous catheter.

ABSTRACTObjective:to determine the incidence rate and risk factors for the nursing-sensitive indicators phlebitis and infiltration in patients with peripheral venous catheters (PVCs). Method:cohort study with 110 patients. Scales were used to assess and document phlebitis and infiltration. Socio-demographic variables, clinical variables related to the PVC, medication and hospitalization variables were collected. Descriptive and inferential analysis and multivariate logistic models were used. Results:the incidence rate of phlebitis and infiltration was respectively 43.2 and 59.7 per 1000 catheter-days. Most PVCs with these vascular traumas were removed in the first 24 hours. Risk factors for phlebitis were: length of hospital stay (p=0.042) and number of catheters inserted (p<0.001); risk factors for infiltration were: piperacillin/tazobactan (p=0.024) and the number of catheters inserted (p<0.001). Conclusion:the investigation documented the incidence of nursing-sensitive indicators (phlebitis and infiltration) and revealed new risk factors related to infiltration. It also allowed a reflection on the nursing care necessary to prevent these vascular traumas and on the indications and contraindications of the PVC, supporting the implementation of the PICC as an alternative to PVC.

Logistic regression analysis on correlative factors of phlebitis caused by iron sucrose injection

Objective To explore the correlative factors of phlebitis caused by iron sucrose injection through intravenous drip in Department of Orthopedics so as to provide a basis for take pertinently preventive steps. Methods A total of 588 inpatients with iron sucrose injection through intravenous drip in Department of Orthopedics of West China Hospital, Sichuan University were selected, by convenient sampling from December 2016 to May 2017. This research recorded the ages, sexes, whether they were with hypertension, body mess index (BMI) , vascular condition, retaining time and models of detaining needle, concentrations of iron saccharate, daily infusion quantity, days using iron saccharate, seniority of puncture nurses, whether there were with phlebitis through the correlative factors of phlebitis caused by iron sucrose injection through intravenous drip record sheet. Single factor and multiple factors Logistic stepwise regression was used to analyze the influencing factors of phlebitis. Results There were 69 cases (11.73%) with phlebitis in patients with ron sucrose injection treatment. Single factor analysis showed that there were statistically significant differences in the incidence of phlebitis among different sexes, daily infusion quantity, vascular condition, retaining time of detaining needle, type of detaining needle concentrations of iron saccharate of patients (χ2=8.654, 32.587, 68.313, 136.206, 10.662, 10.191; P<0.05) . Logistic regression analysis revealed that the independent risk factors of phlebitis caused by iron sucrose injection through intravenous drip included daily infusion quantity, retaining time of detaining needle, concentrations of iron saccharate, and the protective factors of that involved the vascular condition and the type of detaining needle. Conclusions Take pertinently preventive steps actively when patients in Department of Orthopedics are with iron sucrose injection through intravenous drip so as to lessen the suffering of the patients. Key words: Hospital, orthopedic; Phlebitis; Multivariate analysis; Injections, intravenous; Iron sucrose injection; Influencing factors

Risk Factors of Nicardipine-Related Phlebitis in Acute Stroke Patients

Intravenous nicardipine is generally used to treat hypertension in acute stroke patients but is associated with frequent phlebitis. We aimed to identify the incidence and risk factors of phlebitis in such patients. The incidence and risk factors of phlebitis were investigated in 358 acute stroke patients from July 2014 to June 2015. In total, 138 patients received intravenous nicardipine. Of 45 (12.6%) phlebitis patients in 358 acute stroke patients, 42 (93.3%) were administered nicardipine, which was significantly associated with phlebitis occurrence (P < .01). Other candidate risk factors of phlebitis of acute stroke patients in univariate analysis were intracerebral hemorrhage (P < .01), nicardipine injection to paralyzed limbs (P = .023), dilution of nicardipine with normal saline (P < .01), higher maximum flow rate of nicardipine (7.2 ± 4.1 mg/h versus 1.6 ± 3.1 mg/h; P < .01), and higher maximum concentration of nicardipine (271.5 ± 145.0 µg/mL versus 37.6 ± 75.0 µg/mL; P < .01). The only statistically significant independent factor following multivariate logistic regression analysis, according to the optimal cutoff values defined from receiver operating characteristic curve analyses, was the maximum concentration of nicardipine greater than 130 µg/mL (OR 57.9; 95% CI 21.5-156; P < .01). A gradual decline of pH below 4.3 was observed when the concentration of nicardipine solution increased to greater than or equal to 130 µg/mL in vitro. Nicardipine-related phlebitis is frequently observed in acute stroke patients and is significantly associated with administration of a maximum concentration of nicardipine greater than 130 µg/mL.