Construction Of A Risk Assessment Model For Peripheral Venous Catheter-related Phlebitis

ObjectBased on the investigation of the use of peripheral venous catheter(PIVC)in adult patients in grade ? general hospital of suzhou,the influencing factors of phlebitis were analyzed,the Logistic regression algorithm was applied,and a risk assessment model was constructed to provide scientific basis for clinical risk prediction and early intervention of pive-related phlebitis.Methods1.Clinical dataAn investigation was conducted on adult patients with PIVC implanted in 9 grade ?general hospitals in suzhou from December 2017 to February 2018 through a self-designed questionnaire,which mainly included three parts:basic data of patients,basic data of puncturers and relevant information of PIVC use.The inclusion criteria of the subjects were:?patients with PIVC implantation for the first time after admission;??18 years of age;?patients' informed consent and voluntary participation in the study.Exclusion criteria were:?patients brought into PIVC at admission;?ipsilateral limb presence of other types of vascular access devices in patients2.Statistical methodsSAS software was used for statistical analysis.Univariate analysis was performed on the clinical data of 3326 patients involved in the model construction,and multivariate Logistic stepwise regression analysis was performed to screen out the risk factors of pivc-related phlebitis,and a regression equation model was established to predict the risk probability.The effects of the model are evaluated through the Receiver Operating Characteristic Curve(ROC)Area under a Curve(AUC)and Hosmer-Lemeshow goodness of fit test.Results1.Pivc-related phlebitisAmong the 3326 patients used in the model establishment,873 of them developed pivc-related phlebitis,with an incidence of 26.2%.The patients ranged in age from 18 to 102 years old,with a median age of 57(38,69)years old.2.Results of univariate and multivariate analysesThe variables with statistical significance in univariate analysis were patients' age,where the department,piercing history,nearly a week vein puncture title,type,catheter infusion joint type,tube parts,puncture times,type of dressing,types of infusion liquid,infusion method,total day infusion time,infusion,transfusion before flushing,flushing fluid and amount,method of sealing tube,tube sealing liquid and amount,catheter indwelling time(P<0.05).The variables with statistical significance in multivariate Logistic regression analysis were the patient's department,history of venous puncture for nearly one week,joint type,catheter type,catheter location,number of puncture,type of dressing,type of infusion fluid,total daily inftision volume and catheter indwelling time(P<0.05).3.Logistic regression equation model establishment and evaluationEstablish Logistic regression model:LogitP=-0.846-0.576X33+0.824X35+0.306X52+0.798X172-0.667X183+1.191X184+0.456 X193+0.400X202-1.418X203+0.226X232+0.376X242+0.700X282+0.706X283+0.715X284+0.924 X285-1.000X343-2.301X344-2.012X345The sensitivity,specificity and false positive rate(1-specificity)of all cut-off points were calculated automatically by SAS software,and the ROC curve was drawn(figure 1).The area under the ROC curve was 0.785,Hosmer-Lemeshow goodness of fit test ?2 was 10.885,P was 0.208.Conclusion1.Patients in the emergency ward,had a history of venous puncture in the past week,the catheter type was 18G,the number of puncture was 2,irritant drugs were injected,and the total volume of infusion was>500ml,were risk factors of pivc-related phlebitis.2.The risk assessment model of pivc-related phlebitis constructed in this study has moderate prediction effect...