A Prospective Study on the Incidence of Intravenous Catheter-related Complication

Choi, Sun Ju; Cheong, Hee Jin; Woo, Heung Jeong; Kim, Woo Joo; Park, Seung Chull; Park, Chang Hyun

Abstract

BACKGROUND
Intravenous catheter-related complication among the hospitalized patients has been increasing recently in Korea, since many hospitals has tried to save expenses by replacing the foreign-made catheter with domestic-made intravenous catheter. We studied the incidence rate of catheter-related complication and compared the incidence of catheter-related complication between domestic-made and foreign-made ones. We also studied to elucidate whether the morphologic characteristics of the intravenous catheter will effect the incidence of catheter-related complication. METHOD: From July 1 to Sept 30, 1998, we surveyed the incidence rate of intravenous catheter-related complication among the hospitalized patients in the wards of Medicine. Surgery, Obstetric, and Neonatal Intensive Care Unit in Guro Hospital, Korea University Medical center. We also compared the incidence of complication between domestic-made catheter (catheter A) and foreign-made catheter (catheter B) of three different gages (24G, 22G and 18G). The morphologic characteristics of intravenous catheters has been studied by electron microscopy. RESULT: Complication associated with use of intravenous catheter had been occurred 263 out of 459 cases (57.3%), among those cases, non-infectious complication and infectious complication were 173 cases (37.7%) and 90 cases (19.6%), respectively. Totally, catheter A group showed higher complication than catheter B group [62.0% (160/258) vs 51.2% (103/201), P=.021]. Analysis on the incidence rate of complication according to the products did not show significant differences in the noninfectious complication in every gage groups. However the infectious complication occurred higher in the domestic-made catheter A group than among the foreign-made catheter B group [(24G: 6% vs 0%, P=.026), (22G: 25.6% vs 9.6%, P=.001), (18G: 36.8% vs 13.4%, P=.002)]. Duration of catheter life did not show the difference between catheter A group and catheter B group [48.5hrs vs 50.3hrs, P=.474]. The analysis on risk factors for complication showed that catheter A group is highly related (odd ratio 1.85). The morphologic analysis of the catheter by using electron microscopy showed that the angles in the tip of the introducing needle of catheter Aand catheter Bare 60degrees and 45degrees , respectively, and the bevel between introducing needle and catheter sheath are 50degrees and 27degrees, respectively.
CONCLUSION
There was a higher incidence rate of complication related to domestic-made catheter usage, which might influence increasing the period of the hospitalization and the expenses due to the complication. The study of cost effectiveness analysis needs to be performed regarding intravenous catheter-related complication. Morphologically, catheter A showed more blunt angle in the tip and transition area of the introducing needle than the angle of catheter B, which is considered to influence the higher complication incidence. It needs to improve the quality of domestic-made intravenous catheter.