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Risk Factors for Peripheral Intravenous Catheter Failure: A Multivariate Analysis of Data from a Randomized Controlled Trial

Open access
Wallis, Marianne C., McGrail, Matthew, Webster, Joan, Marsh, Nicole, Gowardman, John, Playford, E. Geoffrey, Rickard, Claire M.·2014·Infection Control & Hospital Epidemiology

Abstract

Objective.: To assess the relative importance of independent risk factors for peripheral intravenous catheter (PIVC) failure. Methods.: Secondary data analysis from a randomized controlled trial of PIVC dwell time. The Prentice, Williams, and Peterson statistical model was used to identify and compare risk factors for phlebitis, occlusion, and accidental removal. Setting.: Three acute care hospitals in Queensland, Australia. Participants.: The trial included 3,283 adult medical and surgical patients (5,907 catheters) with a PIVC with greater than 4 days of expected use. Results.: Modifiable risk factors for occlusion included hand, antecubital fossa, or upper arm insertion compared with forearm (hazard ratio [HR], 1.47 [95% confidence interval (CI), 1.28–1.68], 1.27 [95% CI, 1.08–1.49], and 1.25 [95% CI, 1.04–1.50], respectively); and for phlebitis, larger diameter PIVC (HR, 1.48 [95% CI, 1.08–2.03]). PIVCs inserted by the operating and radiology suite staff had lower occlusion risk than ward insertions (HR, 0.80 [95% CI, 0.67–0.94]). Modifiable risks for accidental removal included hand or antecubital fossa insertion compared with forearm (HR, 2.45 [95% CI, 1.93–3.10] and 1.65 [95% CI, 1.23–2.22], respectively), clinical staff insertion compared with intravenous service (HR, 1.69 [95% CI, 1.30–2.20]); and smaller PIVC diameter (HR, 1.29 [95% CI, 1.02–1.61]). Female sex was a nonmodifiable factor associated with an increased risk of both phlebitis (HR, 1.64 [95% CI, 1.28–2.09]) and occlusion (HR, 1.44 [95% CI, 1.30–1.61]). Conclusions.: PIVC survival is improved by preferential forearm insertion, selection of appropriate PIVC diameter, and insertion by intravenous teams and other specialists. Trial Registration.: The original randomized controlled trial on which this secondary analysis is based is registered with the Australian New Zealand Clinical Trials Registry (http://www.anzctr.org.au; ACTRN12608000445370).

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Metadata

Authors
Wallis, M. C., McGrail, M., Webster, J., Marsh, N., Gowardman, J., Playford, E. G., & Rickard, C. M.
Venue
Infection Control & Hospital Epidemiology
Published
2014-01
Volume
35
Issue
1
Pages
63-68
ISSN
  • 0899-823X (ISSN-L)
  • 1559-6834
OpenAlex
W2104419857
Cited by
353
References
27
FWCI
17.71
Type
journal article
Language
en
Open access
bronze

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CoChat. (2026). Citation check: Risk Factors for Peripheral Intravenous Catheter Failure: A Multivariate Analysis of Data from a Randomized Controlled Trial. https://app.cochat.ai/papers/10.1086/674398
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Wallis, M. C., McGrail, M., Webster, J., Marsh, N., Gowardman, J., Playford, E. G., & Rickard, C. M. (2014). Risk Factors for Peripheral Intravenous Catheter Failure: A Multivariate Analysis of Data from a Randomized Controlled Trial. Infection Control & Hospital Epidemiology. https://doi.org/10.1086/674398

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