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Published in: Supportive Care in Cancer 3/2021

01-03-2021 | Original Article

Inherent and modifiable risk factors for peripheral venous catheter failure during cancer treatment: a prospective cohort study

Authors: Emily N. Larsen, Nicole Marsh, Catherine O’Brien, Emily Monteagle, Christopher Friese, Claire M. Rickard

Published in: Supportive Care in Cancer | Issue 3/2021

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Abstract

Purpose

To identify modifiable and non-modifiable risk factors for peripheral intravenous catheter (PIV) failure among patients requiring intravenous treatment for oncology and haematology conditions.

Methods

A single-centre prospective cohort study was conducted between October 2017 and February 2019. Adult in-patients requiring a PIV for therapy were prospectively recruited from two cancer units at a tertiary hospital in Queensland, Australia. The primary outcome was a composite of complications leading to PIV failure (local and bloodstream infection; occlusion; infiltration/extravasation; leakage; dislodgement; and/or phlebitis). Secondary outcomes were (i) PIV dwell time; (ii) insertion and (iii) failure of a CVAD; (iv) adverse events; (v) length of hospital stay. Outcomes were investigated using Bayesian multivariable linear regression modelling and survival analysis.

Results

Of 200 participants, 396 PIVs were included. PIV failure incidence was 34.9%; the most common failure type was occlusion/infiltration (n = 74, 18.7%), then dislodgement (n = 33, 8.3%), and phlebitis (n = 30, 7.6%). While several patient and treatment risk factors were significant in univariable modelling, in the final multivariable model, only the use of non-sterile tape (external to the primary dressing) was significantly associated with decreased PIV dislodgement (hazard ratio 0.06, 95% confidence interval 0.01, 0.48; p = 0.008).

Conclusion

PIV failure rates among patients receiving cancer treatment are high, the sequelae of which may include delayed treatment and infection. Larger studies on risk factors and interventions to prevent PIV failure in this population are needed; however, the use of secondary securements (such as non-sterile tape) to provide further securement to the primary PIV dressing is particularly important.

Trial registration

Study methods were registered prospectively with the Australian New Zealand Clinical Trials Registry on the 27th March 2017 (ACTRN12617000438358); https://​www.​anzctr.​org.​au/​Trial/​Registration/​TrialReview.​aspx?​id=​372191&​isReview=​true
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Metadata
Title
Inherent and modifiable risk factors for peripheral venous catheter failure during cancer treatment: a prospective cohort study
Authors
Emily N. Larsen
Nicole Marsh
Catherine O’Brien
Emily Monteagle
Christopher Friese
Claire M. Rickard
Publication date
01-03-2021
Publisher
Springer Berlin Heidelberg
Published in
Supportive Care in Cancer / Issue 3/2021
Print ISSN: 0941-4355
Electronic ISSN: 1433-7339
DOI
https://doi.org/10.1007/s00520-020-05643-2

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