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
IntroductionPhlebitis 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 an...
| Main Authors: | , , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Frontiers Media S.A.
2022-11-01
|
| Series: | Frontiers in Medicine |
| Subjects: | |
| Online Access: | https://www.frontiersin.org/articles/10.3389/fmed.2022.1037274/full |
| _version_ | 1811211135924305920 |
|---|---|
| author | Masahiro Kashiura Hideto Yasuda Hideto Yasuda Takatoshi Oishi Yuki Kishihara Takashi Moriya Yuki Kotani Natsuki Kondo Kosuke Sekine Nobuaki Shime Keita Morikane |
| author_facet | Masahiro Kashiura Hideto Yasuda Hideto Yasuda Takatoshi Oishi Yuki Kishihara Takashi Moriya Yuki Kotani Natsuki Kondo Kosuke Sekine Nobuaki Shime Keita Morikane |
| author_sort | Masahiro Kashiura |
| collection | DOAJ |
| description | IntroductionPhlebitis 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).Materials and methodsThis 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.ResultsA 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.ConclusionWe 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. |
| first_indexed | 2024-04-12T05:07:37Z |
| format | Article |
| id | doaj.art-e5417738d083419181139b7de09d0b1e |
| institution | Directory Open Access Journal |
| issn | 2296-858X |
| language | English |
| last_indexed | 2024-04-12T05:07:37Z |
| publishDate | 2022-11-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Medicine |
| spelling | doaj.art-e5417738d083419181139b7de09d0b1e2022-12-22T03:46:51ZengFrontiers Media S.A.Frontiers in Medicine2296-858X2022-11-01910.3389/fmed.2022.10372741037274Risk factors for peripheral venous catheter-related phlebitis stratified by body mass index in critically ill patients: A post-hoc analysis of the AMOR-VENUS studyMasahiro Kashiura0Hideto Yasuda1Hideto Yasuda2Takatoshi Oishi3Yuki Kishihara4Takashi Moriya5Yuki Kotani6Natsuki Kondo7Kosuke Sekine8Nobuaki Shime9Keita Morikane10Department of Emergency and Critical Care Medicine, Jichi Medical University Saitama Medical Center, Saitama, JapanDepartment of Emergency and Critical Care Medicine, Jichi Medical University Saitama Medical Center, Saitama, JapanDivision of Clinical Research Education and Training, Clinical and Translational Research Center, Keio University Hospital, Tokyo, JapanDepartment of Emergency and Critical Care Medicine, Jichi Medical University Saitama Medical Center, Saitama, JapanDepartment of Emergency and Critical Care Medicine, Jichi Medical University Saitama Medical Center, Saitama, JapanDepartment of Emergency and Critical Care Medicine, Jichi Medical University Saitama Medical Center, Saitama, JapanDepartment of Intensive Care Medicine, Kameda Medical Center, Chiba, JapanDepartment of Intensive Care Medicine, Chiba Emergency Medical Center, Chiba, JapanDepartment of Medical Engineer, Kameda Medical Center, Chiba, JapanDepartment of Emergency and Critical Care Medicine, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, JapanDivision of Clinical Laboratory and Infection Control, Yamagata University Hospital, Yamagata, JapanIntroductionPhlebitis 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).Materials and methodsThis 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.ResultsA 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.ConclusionWe 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.https://www.frontiersin.org/articles/10.3389/fmed.2022.1037274/fullbody mass indexcatheter-related infectionscathetersintensive care unitsphlebitis |
| spellingShingle | Masahiro Kashiura Hideto Yasuda Hideto Yasuda Takatoshi Oishi Yuki Kishihara Takashi Moriya Yuki Kotani Natsuki Kondo Kosuke Sekine Nobuaki Shime Keita Morikane 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 Frontiers in Medicine body mass index catheter-related infections catheters intensive care units phlebitis |
| title | 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 |
| title_full | 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 |
| title_fullStr | 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 |
| title_full_unstemmed | 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 |
| title_short | 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 |
| title_sort | 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 |
| topic | body mass index catheter-related infections catheters intensive care units phlebitis |
| url | https://www.frontiersin.org/articles/10.3389/fmed.2022.1037274/full |
| work_keys_str_mv | AT masahirokashiura riskfactorsforperipheralvenouscatheterrelatedphlebitisstratifiedbybodymassindexincriticallyillpatientsaposthocanalysisoftheamorvenusstudy AT hidetoyasuda riskfactorsforperipheralvenouscatheterrelatedphlebitisstratifiedbybodymassindexincriticallyillpatientsaposthocanalysisoftheamorvenusstudy AT hidetoyasuda riskfactorsforperipheralvenouscatheterrelatedphlebitisstratifiedbybodymassindexincriticallyillpatientsaposthocanalysisoftheamorvenusstudy AT takatoshioishi riskfactorsforperipheralvenouscatheterrelatedphlebitisstratifiedbybodymassindexincriticallyillpatientsaposthocanalysisoftheamorvenusstudy AT yukikishihara riskfactorsforperipheralvenouscatheterrelatedphlebitisstratifiedbybodymassindexincriticallyillpatientsaposthocanalysisoftheamorvenusstudy AT takashimoriya riskfactorsforperipheralvenouscatheterrelatedphlebitisstratifiedbybodymassindexincriticallyillpatientsaposthocanalysisoftheamorvenusstudy AT yukikotani riskfactorsforperipheralvenouscatheterrelatedphlebitisstratifiedbybodymassindexincriticallyillpatientsaposthocanalysisoftheamorvenusstudy AT natsukikondo riskfactorsforperipheralvenouscatheterrelatedphlebitisstratifiedbybodymassindexincriticallyillpatientsaposthocanalysisoftheamorvenusstudy AT kosukesekine riskfactorsforperipheralvenouscatheterrelatedphlebitisstratifiedbybodymassindexincriticallyillpatientsaposthocanalysisoftheamorvenusstudy AT nobuakishime riskfactorsforperipheralvenouscatheterrelatedphlebitisstratifiedbybodymassindexincriticallyillpatientsaposthocanalysisoftheamorvenusstudy AT keitamorikane riskfactorsforperipheralvenouscatheterrelatedphlebitisstratifiedbybodymassindexincriticallyillpatientsaposthocanalysisoftheamorvenusstudy |