Fibroblastic sleeve and short peripheral catheter failures: Impact of risk factors

Introduction: Short peripheral catheters (SPC) are commonly used in hospitalized patients to provide vascular access for short-term intravenous therapies. However, complications such as infection, thrombophlebitis, and fibroblastic sleeve formation can lead to premature catheter failure, negatively impacting patient care and increasing healthcare costs. Objective: This study aims to identify risk factors associated with fibroblastic sleeve formation and evaluate their role in SPC failure, thereby supporting improved risk stratification and catheter management. Methods: This is a secondary analysis of a prospective observational study involving 200 devices, monitored daily with ultrasound to detect complications, including fibroblastic sleeves. Patient-related and therapy-related risk factors were analyzed using univariate and multivariate Cox models to identify predictors of fibroblastic sleeve formation and device failure. Results: Of the 200 catheters, 94 (47%) developed fibroblastic sleeves detectable by ultrasound. In multivariate analysis, antibiotic therapy requiring central venous access was the only independent predictor of its formation ( p = 0.03; HR, 2.09; 95% CI, 1.08–4.03). Risk factors independently associated with failure included older age, diabetes, cancer, bedridden status, use of antibiotics requiring central access, and omeprazole infusion. Conclusions: Antibiotic infusion through short peripheral catheters was identified as a key risk factor for fibroblastic sleeve formation, while patient-related factors and specific therapies were associated with catheter failure. These findings underscore the importance of selecting and monitoring devices carefully in high-risk patients to minimize complications and enhance vascular access outcomes.