Risk factors for PICC-associated phlebitis in preterm infants using random forest algorithm

Area of Science:

• Neonatal intensive care
• Vascular access devices
• Clinical complications

Background:

• Peripherally inserted central catheters (PICCs) are crucial for critically ill neonates in the neonatal intensive care unit (NICU).
• Phlebitis is a common complication impacting PICC functionality, with limited research on its incidence and risk factors in preterm infants.

Purpose of the Study:

• To determine the incidence of PICC-associated phlebitis in preterm infants.
• To identify risk factors associated with PICC-associated phlebitis in this population.

Main Methods:

• A single-center retrospective cohort study was conducted from January 2019 to December 2023.
• Clinical data from 536 preterm infants with PICC placement were analyzed.
• Random forest and LASSO regression models were used to explore risk factors.

Main Results:

• The incidence of PICC-associated phlebitis was 30.0% (161/536).
• Key risk factors identified include non-central PICCs, ≥5 insertion attempts, and lower limb venous catheterization.
• Other contributing factors included postmenstrual age, weight at catheterization, gender, left limb catheterization, and bronchopulmonary dysplasia (BPD).

Conclusions:

• PICC-associated phlebitis occurs frequently in preterm infants within the NICU.
• Non-central PICCs, multiple insertion attempts (≥5), and lower limb venous catheterization are significant risk factors.
• These findings highlight areas for potential intervention to reduce phlebitis rates.