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.