Peripheral Intravenous Catheters in Hospitalized Surgical Patients: A US Real-World Data Analysis

Background Limited evidence exists to evaluate the clinical and economic burden of treating hospitalized surgical patients experiencing peripheral intravenous catheter (PIVC)–associated complications. Objective To estimate the prevalence of PIVC-associated complications and compare the healthcare resource use and cost between surgical inpatients with and without a PIVC-associated complication. Methods This retrospective cohort study used a large, geographically diverse, hospital-based US database (Premier Healthcare Database). Hospitalized adult (≥18 years) and pediatric (<18 years) patients undergoing a surgery between January 1, 2019, and December 31, 2023, without the use of central line access device were included. Results The analysis included 6 992 120 adult and 159 256 pediatric patients. In the adult cohort, the prevalence of PIVC-associated complications was 0.7%. Patients with complications were older (mean, 64.2 vs 55.2 years) and more likely to be men (53.1% vs 36.6%) than those without complications (both P < .01). Patients with complications were 46% more likely to be readmitted for any reason (odds ratio [OR], 1.46; 95% confidence interval [CI], 1.42-1.50), had longer length of stay (LOS) by 5.52 days, and incurred higher costs by $19 074 than patients without complications, after adjusting for covariates (all P  < .01). In the pediatric cohort, the prevalence of PIVC-associated complications was 0.5%. Patients with complications were younger (mean, 8.6 vs 9.6 years) and more likely to be Black (19.9% vs 15.6%) than those without complications (both P  < .01). Patients with complications were 115% more likely to be readmitted for any reason within 30 days after discharge (OR, 2.15; 95% CI, 1.73-2.67), had longer LOS by 4.50 days, and incurred higher costs by $16 052 than patients without complications, after adjusting for covariates (all P  < .01). Discussion While the overall prevalence of PIVC-associated complications is around 1%, this still amounts to a significant number of patients as most patients undergoing an inpatient surgical procedure would have a PIVC placed. The study results call for stakeholders to establish a process for decreasing complications related to PIVCs. Conclusions In both adult and pediatric cohorts, patients with PIVC-associated complications had significantly higher total hospitalization cost, LOS, and 30-day readmission risks than those without complications.