scholarly journals Risk Factors for Peripheral Intravenous Catheter Failure: A Multivariate Analysis of Data from a Randomized Controlled Trial

2014 ◽  
Vol 35 (1) ◽  
pp. 63-68 ◽  
Author(s):  
Marianne C. Wallis ◽  
Matthew McGrail ◽  
Joan Webster ◽  
Nicole Marsh ◽  
John Gowardman ◽  
...  
Keyword(s):  
Risk Factors ◽  
Randomized Controlled Trial ◽  
Controlled Trial ◽  
Secondary Analysis ◽  
Secondary Data ◽  
Intravenous Catheter ◽  
Antecubital Fossa ◽  
Randomized Controlled ◽  
Increased Risk ◽  
Peripheral Intravenous Catheter

Objective.To assess the relative importance of independent risk factors for peripheral intravenous catheter (PIVC) failure.Methods.Secondary data analysis from a randomized controlled trial of PIVC dwell time. The Prentice, Williams, and Peterson statistical model was used to identify and compare risk factors for phlebitis, occlusion, and accidental removal.Setting.Three acute care hospitals in Queensland, Australia.Participants.The trial included 3,283 adult medical and surgical patients (5,907 catheters) with a PIVC with greater than 4 days of expected use.Results.Modifiable risk factors for occlusion included hand, antecubital fossa, or upper arm insertion compared with forearm (hazard ratio [HR], 1.47 [95% confidence interval (CI), 1.28–1.68], 1.27 [95% CI, 1.08–1.49], and 1.25 [95% CI, 1.04–1.50], respectively); and for phlebitis, larger diameter PIVC (HR, 1.48 [95% CI, 1.08–2.03]). PIVCs inserted by the operating and radiology suite staff had lower occlusion risk than ward insertions (HR, 0.80 [95% CI, 0.67–0.94]). Modifiable risks for accidental removal included hand or antecubital fossa insertion compared with forearm (HR, 2.45 [95% CI, 1.93–3.10] and 1.65 [95% CI, 1.23–2.22], respectively), clinical staff insertion compared with intravenous service (HR, 1.69 [95% CI, 1.30–2.20]); and smaller PIVC diameter (HR, 1.29 [95% CI, 1.02–1.61]). Female sex was a nonmodifiable factor associated with an increased risk of both phlebitis (HR, 1.64 [95% CI, 1.28–2.09]) and occlusion (HR, 1.44 [95% CI, 1.30–1.61]).Conclusions.PIVC survival is improved by preferential forearm insertion, selection of appropriate PIVC diameter, and insertion by intravenous teams and other specialists.Trial Registration.The original randomized controlled trial on which this secondary analysis is based is registered with the Australian New Zealand Clinical Trials Registry (http://www.anzctr.org.au; ACTRN12608000445370).

scholarly journals Risk factors for complications in peripheral intravenous catheters in adults: secondary analysis of a randomized controlled trial

2016 ◽  
Vol 24 (0) ◽  
Author(s):  
Derdried Athanasio Johann ◽  
Mitzy Tannia Reichembach Danski ◽  
Stela Adami Vayego ◽  
Dulce Aparecida Barbosa ◽  
Jolline Lind
Keyword(s):  
Risk Factors ◽  
Randomized Controlled Trial ◽  
Controlled Trial ◽  
Secondary Analysis ◽  
Secondary Data ◽  
Antimicrobial Use ◽  
Randomized Controlled ◽  
Clinical Trials Registry ◽  
Intravenous Catheters

ABSTRACT Objective: analyze the risk factors linked to complications in peripheral intravenous catheters. Method: secondary data analysis of a randomized controlled trial with 169 medical and surgical patients placed in two groups, one with integrated safety catheter (n=90) and other using simple needle catheter (n=79), with three months follow-up time. Results: the risk factors that raised the odds of developing complications were: hospitalization between 10-19 days (p=0.0483) and 20-29 days (p=0,0098), antimicrobial use (p=0.0288) and use of fluid solutions (p=0.0362). The 20 Gauge lowered the risks of complications (p=0.0153). Multiple analysis showed reduction of risk for the 20 Gauge (p=0.0350); heightened risk for solutions and fluids (p=0.0351) and use of corticosteroids (p=0.0214). Conclusion: risk factors linked to complications in peripheral intravenous catheters were: hospitalization periods between 10-29 days, antimicrobial infusion, solutions and fluids and corticosteroids. Regarding complications, 20 Gauge is a protecting factor compared with 22. Brazilian Clinical Trials Registry: RBR-46ZQR8.

scholarly journals Routine Replacement versus Clinical Monitoring of Peripheral Intravenous Catheters in a Regional Hospital in the Home Program A Randomized Controlled Trial

2009 ◽  
Vol 30 (9) ◽  
pp. 915-917 ◽  
Author(s):  
Patricia Van Donk ◽  
Claire M. Rickard ◽  
Matthew R. McGrail ◽  
Glenn Doolan
Keyword(s):  
Randomized Controlled Trial ◽  
Controlled Trial ◽  
Bloodstream Infections ◽  
Clinical Indication ◽  
Intravenous Catheter ◽  
Home Setting ◽  
Home Program ◽  
Randomized Controlled ◽  
Peripheral Intravenous Catheter ◽  
Intravenous Catheters

This randomized, controlled trial involving 316 patients in the home setting found no difference in the rate of phlebitis and/or occlusion among patients for whom a peripheral intravenous catheter was routinely resited at 72-96 hours and those for whom it was replaced only on clinical indication (76.8 events per 1,000 device-days vs 87.3 events per 1,000 device-days; P = .71). There were no bloodstream infections.

scholarly journals The Brain in Motion II Study: study protocol for a randomized controlled trial of an aerobic exercise intervention for older adults at increased risk of dementia

Trials ◽  
2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Renata L. Krüger ◽  
Cameron M. Clark ◽  
Adrienna M. Dyck ◽  
Todd J. Anderson ◽  
Fiona Clement ◽  
...  
Keyword(s):  
Risk Factors ◽  
Randomized Controlled Trial ◽  
Aerobic Exercise ◽  
Health Behaviour ◽  
Exercise Intervention ◽  
Controlled Trial ◽  
Randomized Controlled ◽  
Behavioural Support ◽  
Support Programme ◽  
Increased Risk

Abstract Background There remains no effective intervention capable of reversing most cases of dementia. Current research is focused on prevention by addressing risk factors that are shared between cardiovascular disease and dementia (e.g., hypertension) before the cognitive, functional, and behavioural symptoms of dementia manifest. A promising preventive treatment is exercise. This study describes the methods of a randomized controlled trial (RCT) that assesses the effects of aerobic exercise and behavioural support interventions in older adults at increased risk of dementia due to genetic and/or cardiovascular risk factors. The specific aims are to determine the effect of aerobic exercise on cognitive performance, explore the biological mechanisms that influence cognitive performance after exercise training, and determine if changes in cerebrovascular physiology and function persist 1 year after a 6-month aerobic exercise intervention followed by a 1-year behavioural support programme (at 18 months). Methods We will recruit 264 participants (aged 50–80 years) at elevated risk of dementia. Participants will be randomly allocated into one of four treatment arms: (1) aerobic exercise and health behaviour support, (2) aerobic exercise and no health behaviour support, (3) stretching-toning and health behaviour support, and (4) stretching-toning and no health behaviour support. The aerobic exercise intervention will consist of three supervised walking/jogging sessions per week for 6 months, whereas the stretching-toning control intervention will consist of three supervised stretching-toning sessions per week also for 6 months. Following the exercise interventions, participants will receive either 1 year of ongoing telephone behavioural support or no telephone support. The primary aim is to determine the independent effect of aerobic exercise on a cognitive composite score in participants allocated to this intervention compared to participants allocated to the stretching-toning group. The secondary aims are to examine the effects of aerobic exercise on a number of secondary outcomes and determine whether aerobic exercise-related changes persist after a 1-year behavioural support programme (at 18 months). Discussion This study will address knowledge gaps regarding the underlying mechanisms of the pro-cognitive effects of exercise by examining the potential mediating factors, including cerebrovascular/physiological, neuroimaging, sleep, and genetic factors that will provide novel biologic evidence on how aerobic exercise can prevent declines in cognition with ageing. Trial registration ClinicalTrials.gov NCT03035851. Registered on 30 January 2017

scholarly journals Predictors of Engagement, Response to Follow Up, and Extent of Alcohol Reduction in Users of a Smartphone App (Drink Less): Secondary Analysis of a Factorial Randomized Controlled Trial (Preprint)

2018 ◽  
Author(s):  
Claire Garnett ◽  
Olga Perski ◽  
Ildiko Tombor ◽  
Robert West ◽  
Susan Michie ◽  
...  
Keyword(s):  
Randomized Controlled Trial ◽  
Alcohol Consumption ◽  
Controlled Trial ◽  
Evaluation Research ◽  
Secondary Analysis ◽  
Secondary Data ◽  
Female Gender ◽  
Randomized Controlled ◽  
Alcohol Reduction

BACKGROUND Digital interventions for alcohol can help achieve reductions in hazardous and harmful alcohol consumption. The Drink Less app was developed using evidence and theory, and a factorial randomized controlled trial (RCT) suggested that 4 of its intervention modules may assist with drinking reduction. However, low engagement is an important barrier to effectiveness, and low response to follow up is a challenge for intervention evaluation. Research is needed to understand what factors influence users’ level of engagement, response to follow up, and extent of alcohol reduction. OBJECTIVE This study aimed to investigate associations between user characteristics, engagement, response to follow up, and extent of alcohol reduction in an app-based intervention, Drink Less. METHODS This study involved a secondary data analysis of a factorial RCT of the Drink Less app. Participants (N=672) were aged 18 years or older, lived in the United Kingdom, and had an Alcohol Use Disorders Identification Test score >7 (indicative of excessive drinking). Sociodemographic and drinking characteristics were assessed at baseline. Engagement was assessed in the first month of use (number of sessions, time on app, number of days used, and percentage of available screens viewed). Response to follow up and extent of alcohol reduction (change in past week consumption) were measured after 1 month. Associations were assessed using unadjusted and adjusted linear or logistic regression models. RESULTS Age (all unstandardized regression coefficients [B] >.02, all P<.001) and post-16 educational qualifications (all B>.18, all P<.03) were positively associated with all engagement outcomes. Age (odds ratio [OR] 1.04, P<.001), educational qualifications (OR 2.11, P<.001), and female gender (OR 1.58, P=.02) were positively associated with response to follow up. Engagement outcomes predicted response to follow up (all OR>1.02, all P<.001) but not the extent of alcohol reduction (all −.14<B<−.06, all P>.07). Baseline drinking characteristics were the only variables associated with the extent of alcohol reduction among those followed up (all B>.49, all P<.001). CONCLUSIONS Users of the alcohol reduction app, Drink Less, who were older and had post-16 educational qualifications engaged more and were more likely to respond at 1-month follow up. Higher baseline alcohol consumption predicted a greater extent of alcohol reduction among those followed up but did not predict engagement or response to follow up. Engagement was associated with response to follow up but was not associated with the extent of alcohol reduction, which suggests that the Drink Less app does not have a dose-response effect. CLINICALTRIAL International Standard Randomised Controlled Trial Number ISRCTN40104069; http://www.isrctn.com/ISRCTN40104069 (Archived by WebCite at http://www.webcitation.org/746HqygIV)

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