Cross-Sectional Epidemiology of Phlebitis and Catheter-Related Infections

OBJECTIVES: To describe the characteristics and the problems arising from the use of vascular catheterization in a general hospital and to identify avoidable risk factors associated with catheter-related infections. DESIGN: Cross-sectional, including the entire hospitalized population. SETTING: A university-affiliated hospital. RESULTS: Three-hundred fifty-three intravascular catheters were implanted in 315 of a total of 1,838 hospitalized patients (17.1%, confidence interval [CI] = 15.7-18.5). Of the 353 intravascular catheters, 26 (7.3%) were intra-arterial, 273 (77.3%) were peripheral, and 54 (15.3%) were central. The median (range) duration of the catheterization was 3 (1-11) days for arterial catheters, 1 (1-24) for peripheral catheters, and 5 (1-130) for central catheters. Fifty-three (15%, CI = 11.5-19.5) showed signs of infection. Independent risk factors associated with infection were the presence of infection located elsewhere (odds ratio [OR] = 8.7, CI = 4.13-18.3, p less than .0001), inappropriate catheter care (OR = 5.3, CI = 2.5-11.2, p less than .0001), inappropriate length of catheter use (OR = 3.5, CI = 1.4-9.02, p less than .01), and duration of hospitalization exceeding 14 days (OR = 2.6, CI = 0.9-7.83, p = .07). CONCLUSION: The risk factors associated with catheter-related infections suggest that many are preventable by improved protocols for management. This hypothesis can easily be tested.