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

Xing Sun1, Wei Xu1, Qianqian Wang1

  • 1Women's Hospital of Nanjing Medical University/Nanjing Women and Children's Healthcare Hospital, 123 Tianfei Road, Nanjing, 210004, China.

European Journal of Medical Research
|January 29, 2026
PubMed
Summary
This summary is machine-generated.

The incidence of peripherally inserted central catheter (PICC)-associated phlebitis in preterm infants is high at 30%. Non-central PICCs, multiple insertion attempts, and lower limb catheterization are significant risk factors.

Keywords:
Peripherally inserted central catheterPhlebitisPreterm infantsRandom forestRisk factors

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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.