Time to Develop Phlebitis and Its Predictors Among Patients with Peripheral Intravenous Cannula at Public Hospitals of Bahir Dar City, Amhara, Ethiopia, 2022: A Prospective Observational Study

Abstract

Background

Phlebitis is an inflammation of vein and the common complication of peripheral intravenous cannula. Phlebitis leads patient to sepsis, pulmonary embolism and other serious complications that increase patient morbidity and mortality. Phlebitis-related literature is scarce in Ethiopia. Therefore, the incidence and predictors of phlebitis were the focus of this study.

Methods and Materials

An institution-based prospective observational study was carried out at public hospitals of Bahir Dar city. Four hundred sixty-two patients with peripheral intravenous cannulas who were admitted to the medical ward were selected using a systematic random sampling technique. Jackson’s Visual Infusion Phlebitis Scoring system was used to determine the presence of phlebitis. We used Cox proportional hazards regression model, to identify significant predictors of phlebitis.

Results

In this study, 462 patients included, and 171 (37.01%) of them developed phlebitis. The median survival time of phlebitis was six days. Patients whose age group >60 years had low probability to develop phlebitis (AHR = 0.49, 95% CI 0.29–0.82), whereas chronic-diseases (AHR = 1.50, 95% CI 1.09–2.07), drugs and blood administer in one vein (AHR = 2.03, 95% CI 1.44–2.86), inappropriate cannula dressing (AHR = 1.81, 95% CI 1.31–2.51), large cannula size (AHR = 1.52, 95% CI 1.08–2.15) and longer cannula dwelling time (AHR = 7.39, 95% CI 4.12–13.32) had high probability to develop phlebitis.

Conclusion

The post-peripheral intravenous cannula phlebitis that frequently affects hospitalized cannulated patients requires particular attention and follow-up for cannulated patients with known risk factors.

Keywords:

• time
• incidence
• predictors
• phlebitis
• cannula
• patients

Abbreviations

AIDS, Acquired Immune Deficiency Syndrome; BDU, Bahir Dar University; DVT, Deep Vein Thrombosis; HR, Hazard Ratio; HIV, Human Immune Virus; PIVC, Peripheral Intravenous Cannula; VIPS, Visual Infusion Phlebitis Score.

Availability of the Data

The data used to support the findings of this study are available from one of the authors for reasonable request.

Ethical Approval and Consent

Ethical clearance was obtained from Institutional Review Board (IRB) of Bahir Dar University College of Medicine and Health Sciences. A letter of cooperation was written for all public hospitals of Bahir Dar city with a letter written on April/22, 2022, with a protocol number of 418/2022. During the study period, written informed consent was taken from each patient that participated in this study. However, for patients whose age was under 18 years, informed consent was taken from the parent. Confidentiality of the information was secured throughout the study by excluding names and patient medical record numbers on the data extraction form and the data were used only for the proposed study. This study followed the ethical standard of the declaration of Helsinki.

Acknowledgment

We want to acknowledge Bahir Dar University for the opportunity and financial aid to collect these study data. We would like to extend our sincere thanks to the employees of public hospitals of Bahir Dar city (research coordinator, ward coordinator, card room workers, and others) for their help during the data collection for this thesis.

Author Contributions

All authors made a significant contribution to the work reported, whether that is in the conception, study design, execution, acquisition of data, analysis and interpretation, or in all these areas; took part in drafting, revising or critically reviewing the article; gave final approval of the version to be published; have agreed on the journal to which the article has been submitted; and agree to be accountable for all aspects of the work.

Disclosure

This paper is based on the thesis of Tadios Lidetu, Alemshet Yirga and Elisabet Mesfin Alene. It has been uploaded on the website of College of Medicine and Health Sciences, Bahir Dar University. Even if, the thesis has been uploaded on the institutional website, it does not mean thesis publication in formal way. The authors report no conflicts of interest in this work.

Additional information

Funding

The funding source for the current research is from Bahir Dar University College of Medicine and Health Sciences. The funder had no role in the data collection, analysis, drafting, manuscript, preparation, and publication of this paper.