Time to phlebitis onsite and its predictors among admitted patients with peripheral intravenous cannulas at Debre Markos Comprehensive Specialized Hospital, Northwest Ethiopia, 2024/ 2025: A prospective follow-up study

TL;DR

This study found that nearly 40% of hospitalized patients with IV cannulas developed phlebitis, with key risk factors including female sex, larger cannulas, blood transfusions, and certain medications.

Contribution

The study identifies specific predictors and timing of phlebitis onset in an Ethiopian hospital setting, where such data was previously scarce.

Findings

The cumulative incidence of phlebitis was 39.25% with a median onset time of 5 days.

Female sex, 18-gauge cannula use, blood transfusions, and administration of potassium chloride and vancomycin were significant predictors.

The findings highlight a high incidence and short onset time of phlebitis in hospitalized patients.

Abstract

Phlebitis due to peripheral intravenous cannulation is a common issue in hospitalized patients which leading to serious complications such as deep vein and pulmonary thromboembolism, and septicemia. Understanding the time to phlebitis onset and its predictors is of clinical importance. However, data on its incidence, contributing factors, and time of onset remain limited in Ethiopia. Given the scarcity of compressive studies conducted in Ethiopia and the critical knowledge gap on the incidence, predictors, and timing of phlebitis onset, this study is significant in advancing clinical practice by identifying the time to onset of phlebitis and its predictors among hospitalized patients with peripheral intravenous cannulation.

A prospective follow-up study design was conducted on a sample size of 372 participants using structured interviews and observational checklists. Time to phlebitis onset was determined with the Kaplan-Meier method and log-log plots, while predictors were identified using Cox proportional hazards regression.

The cumulative incidence of phlebitis was 39.25% (95% CI: 34.25%–44.41%), with a median onset time of 5 days (IQR 4–6 days). Whereas, the significant predictors were female sex (AHR = 1.58, 95% CI: 1.11–2.25), use of an 18-gauge cannula (AHR = 2.02, 95% CI: 1.20–3.41), receipt of a blood transfusion (AHR = 2.11, 95% CI: 1.14–3.91), and administration of potassium chloride (AHR = 1.93, 95% CI: 1.17–3.19) and vancomycin (AHR = 2.89, 95% CI: 1.73–4.83).

In this study, the incidence of peripheral intravenous cannula-induced phlebitis was high, with a lower median time of phlebitis onset. The key predictors were female sex, large cannula, receipt of a blood transfusion, and administration of potassium chloride and vancomycin.

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