Risk Factors for Midline Catheter Failure: A Secondary Analysis of an Existing Trial

Figures & data

Table 1 Patient and Catheter-Related Characteristics

Variables*
n	191
Patient Characteristics
Age, years	60.2 (16.7)
Sex
Male	77 (40.3%)
Female	114 (59.7%)
BMI, kg/m^2
<30	92 (48.2%)
≥30	99 (51.8%)
Systolic blood pressure, mmHg	128.5 (20.0)
Pulse, beats per minute	81.9 (16.1)
Blood oxygen saturation, %
<93	10 (5.2%)
≥93	181 (94.8%)
Body temperature, °C
<38	185 (96.9%)
≥38	6 (3.1%)
Venous thromboembolism (VTE)
No	182 (95.3%)
Yes	9 (4.7%)
Hypercoagulable condition
No	186 (97.4%)
Yes	5 (2.6%)
Major surgery
No	154 (80.6%)
Yes	37 (19.4%)
Immobilization
No	147 (77.0%)
Yes	44 (23.0%)
Reason for catheter placement
Antibiotics	116 (60.7%)
Difficult venous access	62 (32.5%)
Both	13 (6.8%)
Infusates (irritants/vesicants)
No use	119 (62.3%)
Use	72 (37.7%)
Calcium gluconate in dextrose
No	170 (89.0%)
Yes	21 (11.0%)
Norepinephrine in dextrose
No	173 (90.6%)
Yes	18 (9.4%)
Vancomycin
No	178 (93.2%)
Yes	13 (6.8%)
Total dose of infusates (irritants/vesicants)
0	119 (62.3%)
1–2	28 (14.7%)
≥3	44 (23.0%)
PIVC characteristics
Location
Basilic	120 (62.8%)
Brachial	47 (24.6%)
Cephalic	24 (12.6%)
Side
Left	51 (26.7%)
Right	140 (73.3%)
Depth of vein, cm
≤1.2	108 (56.5%)
>1.2	83 (43.5%)
Catheter-to-vein ratio
≤0.40	147 (77.0%)
>0.40	44 (23.0%)
Distance from antecubital fossa, cm
≤7.0	113 (59.2%)
>7.0	78 (40.8%)
Outcome
Line failure
Yes	42 (22.0%)
No	149 (78.0%)

Note: *Data are mean (SD) or n (%) in 191 patients.

Abbreviations: BMI, body mass index; PIVC, peripheral intravenous catheter.

Table 2 Primary Causes of Catheter Removal Among Failed Catheters

Variables
n	42
Cause of Failure
Leaking	14 (33.3%)
Pain	8 (19.0%)
Persistent withdrawal occlusion	7 (16.7%)
Dislodgement	5 (11.9%)
Complete occlusion	4 (9.5%)
Infiltration	4 (9.5%)

Table 3 Univariable and Multivariable Analyses for Midline Catheter Failure

Variables	Univariable Model		Multivariable Model^‡
	HR (95% CI)	p value	aHR (95% CI)	p value
Patient haracteristics
Age, years	1.01 (0.99–1.03)	0.33
Sex
Male	1 [Reference]
Female	1.15 (0.62–2.12)	0.66
BMI, kg/m^2
<30	1 [Reference]
≥30	1.13 (0.62–2.07)	0.70
Systolic blood pressure, mmHg	1.00 (0.98–1.02)	0.91
Pulse, beats per minute	1.02 (1.00–1.04)	0.02	1.01 (0.99–1.03)	0.19
Blood oxygen saturation, %
<93	2.91 (1.03–8.24)	0.04	2.38 (0.79–7.21)	0.13
≥93	1 [Reference]		1 [Reference]
Body temperature, °C
<38	1 [Reference]		1 [Reference]
≥38	5.59 (1.96–15.94)	0.001	2.04 (0.46–9.12)	0.35
Venous thromboembolism (VTE)
No	1 [Reference]
Yes	1.17 (0.28–4.86)	0.83
Hypercoagulable condition
No	NA
Yes	NA	–
Major surgery
No	1 [Reference]
Yes	0.76 (0.32–1.81)	0.54
Immobilization
No	1 [Reference]
Yes	1.68 (0.87–3.23)	0.12
Reason for catheter placement
Antibiotics	1 [Reference]		1 [Reference]
Difficult venous access	1.88 (0.97–3.66)	0.06	2.05 (1.04–4.05)	0.04
Both	4.17 (1.67–10.41)	0.002	2.76 (0.78–9.79)	0.12
Infusates (irritants/vesicants)
No use	1 [Reference]
Use	1.43 (0.78–2.65)	0.25
Calcium gluconate in dextrose
No	1 [Reference]
Yes	0.60 (0.18–1.94)	0.39
Norepinephrine in dextrose
No	1 [Reference]		1 [Reference]
Yes	2.41 (1.17–4.97)	0.02	2.29 (1.09–4.82)	0.03
Vancomycin
No	1 [Reference]
Yes	1.15 (0.40–3.33)	0.80
Total dose of infusates (irritants/vesicants)
0	1 [Reference]
1–2	1.22 (0.49–3.04)	0.67
≥3	1.54 (0.79–3.02)	0.21
PIVC Characteristics
Location
Basilic	1 [Reference]
Brachial	1.35 (0.66–2.72)	0.41
Cephalic	2.47 (1.09–5.57)	0.03
Side
Left	1 [Reference]
Right	1.24 (0.59–2.60)	0.57
Depth of vein, cm
≤1.2	1 [Reference]
>1.2	0.90 (0.49–1.66)	0.74
Catheter-to-vein ratio
≤0.40	1 [Reference]
>0.40	1.52 (0.78–2.97)	0.22
Distance from antecubital fossa, cm
≤7.0	1 [Reference]
>7.0	0.95 (0.51–1.75)	0.86

Notes: ^‡The model assessment indicated the predictive ability (c-statistic) on the occurrence of midline catheter failure was 0.64. Using the bootstrap cross-validation with 1000 bootstrap samples, the estimate of c-statistic was 0.66 (95% CI, 0.56–0.77).

Abbreviations: BMI, body mass index; PIVC, peripheral intravenous catheter; HR, hazard ratio; aHR, adjusted hazard ratio; CI, confidence interval; NA, not available.