Rates of surgical deaths and infections at district hospitals in Malawi and Zambia: a prospective multicentre cohort study

ObjectiveThis paper reports perioperative mortality and postoperative infection rates of surgical patients who underwent operations at district-level hospitals in Malawi and Zambia, and the associations of these outcomes with patient characteristics based on routinely available data.DesignProspective cohort study.SettingEight government district hospitals in Malawi and nine mission and government district hospitals in Zambia.Outcome measuresPerioperative mortality and postoperative infection were used as primary outcome measures in this study. Logistic regression and penalised maximum likelihood logistic regression were used to examine the factors correlated with surgical outcomes.ResultsThe average perioperative mortality rates were 0.19% and 0.43% in Malawi and Zambia, respectively. Penalised maximum likelihood logistic regression showed that age (OR=1.046, 95% CI 1.016 to 1.078) and American Society of Anesthesiologists physical status score II (OR=6.658, 95% CI 2.363 to 18.762) were significantly associated with perioperative deaths. General surgery procedures were significantly more likely than obstetrical procedures to result in perioperative deaths (OR=3.821, 95% CI 1.226 to 11.908). The average rates of postoperative infections in Malawi and Zambia were 2.69% and 2.24%, respectively. Age (OR=1.010, 95% CI 1.000 to 1.020) and male sex (OR=0.407, 95% CI 0.260 to 0.637) were significantly associated with postoperative infections. Additional factors, general procedures (OR=2.319, 95% CI 1.397 to 3.850) and trauma-related procedure (OR=5.490, 95% CI 2.632 to 11.449) were significantly associated with infection rates. There was no significant correlation between surgical outcomes and cadre of lead surgeon (a non-physician clinician or doctor).ConclusionRates of mortality and postoperative infections in this sample of district-level hospitals in Malawi and Zambia were relatively low, with poorer preoperative physical status as the main predictor of both greater postoperative infection and mortality. The study demonstrates that outcomes of major surgical cases do not depend on the cadre (type) of surgeon performing it, and outcomes can be monitored using routine data, at district level in these countries.Trial registration numberISRCTN66099597.

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FAKTOR YANG MEMPENGARUHI KEJADIAN INFEKSI POST OPERASI DI RUANG RANAP WIJAYA KUSUMAH RSUD KOTA BANJAR

Jurnal Keperawatan Galuh ◽

10.25157/jkg.v3i1.6579 ◽

2021 ◽

Vol 3 (1) ◽

pp. 1

Author(s):

Aa Ahmad Suhendar ◽

Nina Rosdiana ◽

Lia Nurhidayah

Keyword(s):

Nutritional Status ◽

Postoperative Infection ◽

Economic Conditions ◽

Public Knowledge ◽

Economic Factors ◽

City Hospital ◽

Infection Rates ◽

Postoperative Infections ◽

Internal Factor ◽

Age Factor

Status gizi, usia dan faktor ekonomi merupakan faktor internal pasien yang mempengaruhi frekuensi infeksi. Masyarakat masih belum mengetahui status gizinya dan tidak dapat memperbaikinya, dengan penyebab yang bervariasi baik dari keadaan ekonomi maupun dari kurangnya pengetahuan masyarakat tentang gizi. Faktor internal lain dalam frekuensi infeksi adalah usia, pada pasien yang lebih tua dari 70 tahun. Faktor usia di atas 70 dapat menurunkan pertahanan tubuh. Tujuan penelitian ini adalah untuk mengetahui faktor-faktor yang mempengaruhi kejadian infeksi post operasi di bangsal Vijaya Kusumah RSUD Kota Banjar. Penelitian ini menggunakan beberapa jenis penelitian korelasi. Populasi penelitian ini terdiri dari seluruh pasien pasca operasi dan sampel sebanyak 21 responden. Alat yang digunakan dalam penelitian ini adalah kuesioner, dan analisis data yang digunakan dalam penelitian ini adalah univariat dan bivariat. Hasil penelitian menunjukkan bahwa tidak ada pengaruh faktor status gizi terhadap kejadian infeksi post operasi, pengaruh faktor status gizi terhadap kejadian infeksi post operasi dan pengaruh faktor ekonomi terhadap kejadian infeksi post operasi. Akibatnya, faktor status gizi tidak mempengaruhi angka infeksi pasca operasi, tetapi faktor status gizi dan tingkat ekonomi ditemukan mempengaruhi angka infeksi pasca operasi. Hasil penelitian ini dimaksudkan untuk digunakan sebagai buku teks dan literatur untuk mengatasi masalah infeksi pasca operasi.Nutritional status, age and economic factors are internal patient factors that affect the frequency of infection. The community still does not know their nutritional status and cannot improve it, with various causes, both from economic conditions and from a lack of public knowledge about nutrition. Another internal factor in the frequency of infection is age, in patients older than 70 years. The age factor over 70 can lower the body's defenses. The purpose of this study was to determine the factors that influence the incidence of postoperative infection in the Vijaya Kusumah ward, Banjar City Hospital. This study uses several types of correlation research. The population of this study consisted of all postoperative patients and a sample of 21 respondents. The instrument used in this study was a questionnaire, and the data analysis used in this study was univariate and bivariate. The results showed that there was no influence of nutritional status factors on the incidence of postoperative infections, the influence of nutritional status factors on the incidence of postoperative infections and the influence of economic factors on the incidence of postoperative infections. As a result, nutritional status factors did not affect postoperative infection rates, but nutritional status factors and economic level were found to influence postoperative infection rates. The results of this study are intended to be used as a textbook and literature to address the problem of postoperative infection.

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Peripheral Vascular Disease is Associated with Increased Risk of Acute Postoperative Infection and Failure of Total Ankle Replacements

Foot & Ankle Orthopaedics ◽

10.1177/2473011419s00149 ◽

2019 ◽

Vol 4 (4) ◽

pp. 2473011419S0014

Author(s):

Matthew S. Conti ◽

Oleksandr Savenkov ◽

Scott J. Ellis

Keyword(s):

Logistic Regression ◽

Risk Factor ◽

Lower Extremity ◽

Vascular Disease ◽

Preoperative Diagnosis ◽

Postoperative Infection ◽

Peripheral Vascular ◽

Postoperative Infections ◽

Irrigation And Debridement ◽

Medicare Patients

Category: Ankle Arthritis Introduction/Purpose: Peripheral vascular disease (PVD) is often cited as a contraindication for total ankle replacement (TAR); however, there are no studies looking at its impact on postoperative complications. The primary purpose of our study was to identify whether preoperative PVD increased the rate of infection, postoperative irrigation and debridement, or failure of the implant in patients undergoing total ankle arthroplasty using a large dataset. Methods: The PearlDiver Database was used to identify Medicare patients who underwent a TAR from 2005 to 2014 using ICD- 9 and CPT codes. The cohort was queried for postoperative infections within 90 days, subsequent irrigation and debridement, and failure of TAR. Failure of TAR was defined was a revision, conversion to tibiotalar arthrodesis, lower extremity amputation, or implant removal. A diagnosis of preoperative PVD only included those patients who had PVD as an ICD-9 diagnosis code and underwent a preoperative lower extremity angiogram prior to TAR. Preoperative co-morbidities including prior corticosteroid injections, diabetes mellitus, smoking, rheumatoid arthritis, congestive heart failure, hypertension, obesity, and end-stage renal disease requiring dialysis were taken into consideration. Three multivariable logistic regression models were then developed in order to identify risk factors associated with postoperative infections and failure after TAR. Results: 10,698 Medicare patients who underwent a primary TAR were identified. 334 patients had a postoperative infection within 90 days of their TAR and 95 of those patients required an irrigation and debridement. Patients with a preoperative diagnosis of PVD had the highest acute infection rate at 10.5% as well as the highest incidence of failure at 12.3%. Multivariable logistic regression modeling demonstrated that patients with PVD had the greatest risk of developing a postoperative infection within 90 days (OR 2.85, 95% CI 1.45-5.13, P<0.01). Preoperative PVD was the most important risk factor for requiring an irrigation and debridement postoperatively (OR 4.87, 95% CI 1.94–10.6, P<0.001) (Table 1) and placed patients at the highest risk of TAR failure (OR 2.67, 95% CI 1.43–4.63, P<0.001). Conclusion: Our study suggests that a preoperative diagnosis of PVD has significant negative effects on outcomes following TAR. Preoperative PVD is an independent risk factor for an acute postoperative infection, postoperative irrigation and debridement, and failure of the implant.

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How the COVID-19 pandemic changed postoperative infections in urology wards: A retrospective cohort study from two urology departments

Canadian Urological Association Journal ◽

10.5489/cuaj.7521 ◽

2021 ◽

Vol 16 (5) ◽

Author(s):

Bernardo L. Teixeira ◽

João Cabral ◽

André Marques-Pinto ◽

Fernando Vila ◽

Joaquim Lindoro ◽

...

Keyword(s):

Cohort Study ◽

Retrospective Cohort Study ◽

Retrospective Cohort ◽

Postoperative Infection ◽

Elective Surgery ◽

Resistant Organism ◽

Relative Reduction ◽

Drug Resistant ◽

Postoperative Infections ◽

Elective Surgical Procedures

Introduction: We aimed to compare the rate of postoperative infection and drug-resistant organism (DRO) before and during the COVID-19 pandemic in urology departments. Methods: A retrospective cohort study was carried out. Data from all elective surgical procedures carried out in two urology departments between April and June 2018 and the homologous period in 2020 were collected. Main outcomes were the number of postoperative infections during the pandemic, and the number of DROs. Sample size was calculated based on a 50% relative reduction of infections during the pandemic. Variables were compared by Chi-squared test, and multivariable logistic regression was used to estimate predictors. Results: A total of 698 patients undergoing elective surgery were included. The postoperative infection rate during the pre-pandemic period was of 14.1% compared to 12.1% during the pandemic (p=0.494). DROs were lower during the pandemic (92.3% vs. 52.4%, p=0.002). The pandemic period was the main predictor for reduced multi-drug-resistant isolates, with an odds ratio of 0.10 (p=0.010, 95% confidence interval 0.016–0.57). Conclusions: Postoperative infection rates were not significantly reduced during the COVID-19 pandemic, despite the adoption of enhanced infection preventive measures. There was, however, a decrease in the rate of DROs during this period, suggesting a secondary benefit to enhanced infection prevention practices adopted during the COVID-19 era.

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P.075 Rates of infection following craniotomy or craniectomy with subsequent cranioplasty in traumatic brain injury

Canadian Journal of Neurological Sciences / Journal Canadien des Sciences Neurologiques ◽

10.1017/cjn.2016.179 ◽

2016 ◽

Vol 43 (S2) ◽

pp. S38-S38

Author(s):

M Cadieux ◽

C Gallagher

Keyword(s):

Traumatic Brain Injury ◽

Brain Injury ◽

Postoperative Infection ◽

Absolute Risk ◽

Absolute Risk Reduction ◽

Infection Rates ◽

Postoperative Infections ◽

Vp Shunt ◽

Post Traumatic ◽

Procedure Type

Background: Postoperative infection is a significant cause of morbidity and mortality in traumatic brain injury (TBI) patients who undergo craniotomy and/or craniectomy. Data on the rates of infections associated with these procedures are limited. We present a single-center retrospective study on the rates of infection in post-traumatic craniotomies, craniectomies and cranioplasties. Methods: Data on 100 TBI adult patients who underwent a craniotomy, craniectomy and/or cranioplasty from 2011-2015 will be analyzed. Demographic and perioperative data including open/closed TBI, peri/postoperative infections, duration of procedure, type and mode of bone flap preservation will be retrieved. Results: Following our data collection (to be completed by the end of February), we expect infection rates of 3-20% in our study. Upon instituting a protocol similar to the Hydrocephalus Clinical Research Network’s (HCRN) ventriculoperitoneal shunt (VP) protocol, we hope to reduce our post-TBI craniotomy/craniectomy/cranioplasty infections rates to less than 10%. Our projection is based on the HCRN protocol’s 3.15% absolute risk reduction of VP shunt infections. Conclusions: The results of this study will emphasize the need for instituting robust perioperative protocols to reduce infections. Further research will be pursued following this study to establish a protocol similar to the VP shunt protocol from the HCRN, in an attempt to reduce perioperative rates of infection.

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387. Markers for Mortality in COVID-19 Patients with Atrial Fibrillation or Flutter

Open Forum Infectious Diseases ◽

10.1093/ofid/ofaa439.582 ◽

2020 ◽

Vol 7 (Supplement_1) ◽

pp. S262-S262

Author(s):

Kok Hoe Chan ◽

Bhavik Patel ◽

Iyad Farouji ◽

Addi Suleiman ◽

Jihad Slim

Keyword(s):

Atrial Fibrillation ◽

Logistic Regression ◽

Cohort Study ◽

Retrospective Cohort Study ◽

Retrospective Cohort ◽

Prognostic Markers ◽

Univariate Analysis ◽

Laboratory Data ◽

Significant Difference ◽

New Onset

Abstract Background Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) infection can lead to many different cardiovascular complications, we were interested in studying prognostic markers in patients with atrial fibrillation/flutter (A. Fib/Flutter). Methods A retrospective cohort study of patients with confirmed COVID-19 and either with existing or new onset A. Fib/Flutter who were admitted to our hospital between March 15 and May 20, 2020. Demographic, outcome and laboratory data were extracted from the electronic medical record and compared between survivors and non-survivors. Univariate and multivariate logistic regression were employed to identify the prognostic markers associated with mortality in patients with A. Fib/Flutter Results The total number of confirmed COVID-19 patients during the study period was 350; 37 of them had existing or new onset A. Fib/Flutter. Twenty one (57%) expired, and 16 (43%) were discharged alive. The median age was 72 years old, ranged from 19 to 100 years old. Comorbidities were present in 33 (89%) patients, with hypertension (82%) being the most common, followed by diabetes (46%) and coronary artery disease (30%). New onset of atrial fibrillation was identified in 23 patients (70%), of whom 13 (57%) expired; 29 patients (78%) presented with atrial fibrillation with rapid ventricular response, and 2 patients (5%) with atrial flutter. Mechanical ventilation was required for 8 patients, of whom 6 expired. In univariate analysis, we found a significant difference in baseline ferritin (p=0.04), LDH (p=0.02), neutrophil-lymphocyte ratio (NLR) (p=0.05), neutrophil-monocyte ratio (NMR) (p=0.03) and platelet (p=0.015) between survivors and non-survivors. With multivariable logistic regression analysis, the only value that had an odds of survival was a low NLR (odds ratio 0.74; 95% confidence interval 0.53–0.93). Conclusion This retrospective cohort study of hospitalized patients with COVID-19 demonstrated an association of increase NLR as risk factors for death in COVID-19 patients with A. Fib/Flutter. A high NLR has been associated with increased incidence, severity and risk for stroke in atrial fibrillation patients but to our knowledge, we are first to demonstrate the utilization in mortality predictions in COVID-19 patients with A. Fib/Flutter. Disclosures Jihad Slim, MD, Abbvie (Speaker’s Bureau)Gilead (Speaker’s Bureau)Jansen (Speaker’s Bureau)Merck (Speaker’s Bureau)ViiV (Speaker’s Bureau)

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Donepezil Combined with DL-3-n-Butylphthalide Delays Cognitive Decline in Patients with Mild to Moderate Alzheimer’s Disease: A Multicenter, Prospective Cohort Study

Journal of Alzheimer s Disease ◽

10.3233/jad-201381 ◽

2021 ◽

Vol 80 (2) ◽

pp. 673-681

Author(s):

Jin Wang ◽

Xiaojuan Guo ◽

Wenhui Lu ◽

Jie Liu ◽

Hong Zhang ◽

...

Keyword(s):

Alzheimer’S Disease ◽

Alzheimer's Disease ◽

Logistic Regression ◽

Regression Analysis ◽

Cohort Study ◽

Prospective Cohort ◽

Daily Living ◽

Multivariate Logistic Regression Analysis ◽

Multivariate Logistic Regression ◽

Significant Difference

Background: Vascular factors and mitochondria dysfunction contribute to the pathogenesis of Alzheimer’s disease (AD). DL-3-n-butylphthalide (NBP) has an effect in protecting mitochondria and improving microcirculation. Objective: The aim was to investigate the effect of donepezil combined NBP therapy in patients with mild-moderate AD. Methods: It was a prospective cohort study. 92 mild-moderate AD patients were classified into the donepezil alone group (n = 43) or the donepezil combined NBP group (n = 49) for 48 weeks. All patients were evaluated with Alzheimer’s Disease Assessment Scale-Cognitive subscale (ADAS-cog), Clinician’s Interview-Based Impression of Change plus caregiver input (CIBIC-plus), Alzheimer’s Disease Cooperative Study-Activities of Daily Living (ADCS-ADL), and Neuropsychiatric Inventory (NPI) every 12 weeks. All patients were monitored for adverse events (AEs). The efficacy was analyzed using multivariate logistic regression analysis. Results: The multivariate logistic regression analysis showed that the changes of ADAS-cog score (OR = 2.778, 95% CI: [1.087, 7. 100], p = 0.033) and ADCS-ADL score (OR = 2.733, 95% CI: [1.002, 7.459], p = 0.049) had significant difference between donepezil alone group and donepezil combined NBP group, while the changes of NPI (OR = 1.145, 95% CI: [0.463, 2.829], p = 0.769), MMSE (OR = 1.563, 95% CI: [0.615, 3.971], p = 0.348) and CIBIC-plus (OR = 2.593, 95% CI: [0.696, 9.685], p = 0.156) had no significant difference. The occurrence of AEs was similar in the two groups. Conclusion: Over the 48-week treatment period, donepezil combined NBP group had slower cognitive decline and better activities of daily living in patients with mild to moderate AD. These indicated that the multi-target therapeutic effect of NBP may be a new choice for AD treatment.

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Prediction of 11-year incidence of psychophysically dependent status or death among community-dwelling younger elderlies: from an age-specified community-based cohort study (the NISSIN project)

Environmental Health and Preventive Medicine ◽

10.1186/s12199-021-00968-8 ◽

2021 ◽

Vol 26 (1) ◽

Author(s):

Satoe Okabayashi ◽

Takashi Kawamura ◽

Hisashi Noma ◽

Kenji Wakai ◽

Masahiko Ando ◽

...

Keyword(s):

Older Adults ◽

Logistic Regression ◽

Cohort Study ◽

Prediction Model ◽

Nursing Care ◽

Family Members ◽

Limited Resource ◽

Community Dwelling ◽

Older Individuals ◽

Regression Analyses

Abstract Background Predicting adverse health events and implementing preventative measures are a necessary challenge. It is important for healthcare planners and policymakers to allocate the limited resource to high-risk persons. Prediction is also important for older individuals, their family members, and clinicians to prepare mentally and financially. The aim of this study is to develop a prediction model for within 11-year dependent status requiring long-term nursing care or death in older adults for each sex. Methods We carried out age-specified cohort study of community dwellers in Nisshin City, Japan. The older adults aged 64 years who underwent medical check-up between 1996 and 2005 were included in the study. The primary outcome was the incidence of the psychophysically dependent status or death or by the end of the year of age 75 years. Univariable logistic regression analyses were performed to assess the associations between candidate predictors and the outcome. Using the variables with p-values less than 0.1, multivariable logistic regression analyses were then performed with backward stepwise elimination to determine the final predictors for the model. Results Of the 1525 female participants at baseline, 105 had an incidence of the study outcome. The final prediction model consisted of 15 variables, and the c-statistics for predicting the outcome was 0.763 (95% confidence interval [CI] 0.714–0.813). Of the 1548 male participants at baseline, 211 had incidence of the study outcome. The final prediction model consisted of 16 variables, and the c-statistics for predicting the outcome was 0.735 (95% CI 0.699–0.771). Conclusions We developed a prediction model for older adults to forecast 11-year incidence of dependent status requiring nursing care or death in each sex. The predictability was fair, but we could not evaluate the external validity of this model. It could be of some help for healthcare planners, policy makers, clinicians, older individuals, and their family members to weigh the priority of support.

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Resuming professional football (soccer) during the COVID-19 pandemic in a country with high infection rates: a prospective cohort study

British Journal of Sports Medicine ◽

10.1136/bjsports-2020-103724 ◽

2021 ◽

pp. bjsports-2020-103724

Author(s):

Yorck Olaf Schumacher ◽

Montassar Tabben ◽

Khalid Hassoun ◽

Asmaa Al Marwani ◽

Ibrahim Al Hussein ◽

...

Keyword(s):

Cohort Study ◽

Prospective Cohort Study ◽

Prospective Cohort ◽

Preventive Measures ◽

Clinical Symptoms ◽

Severe Illness ◽

Football Players ◽

Professional Football ◽

Infection Rates ◽

High Infection

ObjectivesThe risk of viral transmission associated with contact sports such as football (soccer) during the COVID-19 pandemic is unknown. The aim of this study was to describe the infective and immune status of professional football players, team staff and league officials over a truncated football season resumed at the height of the COVID-19 pandemic in a country with high infection rates and to investigate the clinical symptoms related to COVID-19 infection in professional football players.MethodsProspective cohort study of 1337 football players, staff and officials during a truncated football season (9 weeks) with a tailored infection control programme based on preventive measures and regular SARS-CoV-2 PCR swab testing (every 3–5 days) combined with serology testing for immunity (every 4 weeks). Clinical symptoms in positive participants were recorded using a 26-item, Likert-Scale-based scoring system.ResultsDuring the study period, 85 subjects returned positive (cycle threshold (cT) ≤30) or reactive (30<cT<40) PCR tests, of which 36 were players. The infection rate was consistent with that of the general population during the same time period. More than half of infected subjects were asymptomatic, and the remaining had only mild symptoms with no one requiring hospitalisation. Symptom severity was associated with lower cT values. Social contacts and family were the most common sources of infection, and no infection could be traced to training or matches. Of the 36 infected players, 15 presented positive serology during the study period.ConclusionFootball played outdoors involving close contact between athletes represents a limited risk for SARS-CoV-2 infection and severe illness when preventive measures are in place.

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Relation between body composition and severe diarrhea in patients treated with preoperative chemoradiation with capecitabine for rectal cancer: a single-centre cohort study

BMC Gastroenterology ◽

10.1186/s12876-021-01886-3 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

J. M. van Rees ◽

W. Hartman ◽

J. J. M. E. Nuyttens ◽

E. Oomen-de Hoop ◽

J. L. A. van Vugt ◽

...

Keyword(s):

Risk Factors ◽

Rectal Cancer ◽

Body Composition ◽

Logistic Regression ◽

Cohort Study ◽

Preoperative Chemoradiation ◽

Regression Analyses ◽

Single Centre ◽

Severe Diarrhea ◽

The Impact

Abstract Background Chemoradiation with capecitabine followed by surgery is standard care for locally advanced rectal cancer (LARC). Severe diarrhea is considered a dose-limiting toxicity of adding capecitabine to radiation therapy. The aim of this study was to describe the risk factors and the impact of body composition on severe diarrhea in patients with LARC during preoperative chemoradiation with capecitabine. Methods A single centre retrospective cohort study was conducted in a tertiary referral centre. All patients treated with preoperative chemoradiation with capecitabine for LARC from 2009 to 2015 were included. Patients with locally recurrent rectal cancer who received chemoradiation for the first time were included as well. Logistic regression analyses were performed to identify risk factors for severe diarrhea. Results A total of 746 patients were included. Median age was 64 years (interquartile range 57–71) and 477 patients (64%) were male. All patients received a radiation dosage of 25 × 2 Gy during a period of five weeks with either concomitant capecitabine administered on radiation days or continuously during radiotherapy. In this cohort 70 patients (9%) developed severe diarrhea. In multivariable logistic regression analyses female sex (OR: 4.42, 95% CI 2.54–7.91) and age ≥ 65 (OR: 3.25, 95% CI 1.85–5.87) were the only risk factors for severe diarrhea. Conclusions Female patients and patients aged sixty-five or older had an increased risk of developing severe diarrhea during preoperative chemoradiation therapy with capecitabine. No relation was found between body composition and severe diarrhea.

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Risk factors for peripheral venous catheter failure: A prospective cohort study of 5345 patients

The Journal of Vascular Access ◽

10.1177/11297298211015035 ◽

2021 ◽

pp. 112972982110150

Author(s):

Ya-mei Chen ◽

Xiao-wen Fan ◽

Ming-hong Liu ◽

Jie Wang ◽

Yi-qun Yang ◽

...

Keyword(s):

Risk Factors ◽

Logistic Regression ◽

Cohort Study ◽

Goodness Of Fit ◽

Insertion Site ◽

Healthcare Providers ◽

Venous Catheter ◽

Goodness Of Fit Test ◽

Peripheral Venous Catheter ◽

Independent Risk Factors

Purpose: The objective of this study was to determine the independent risk factors associated with peripheral venous catheter (PVC) failure and develop a model that can predict PVC failure. Methods: This prospective, multicenter cohort study was carried out in nine tertiary hospitals in Suzhou, China between December 2017 and February 2018. Adult patients undergoing first-time insertion of a PVC were observed from catheter insertion to removal. Logistic regression was used to identify the independent risk factors predicting PVC failure. Results: This study included 5345 patients. The PVC failure rate was 54.05% ( n = 2889/5345), and the most common causes of PVC failure were phlebitis (16.3%) and infiltration/extravasation (13.8%). On multivariate analysis, age (45–59 years: OR, 1.295; 95% CI, 1.074–1.561; 60–74 years: OR, 1.375; 95% CI, 1.143–1.654; ⩾75 years: OR, 1.676; 95% CI, 1.355–2.073); department (surgery OR, 1.229; 95% CI, 1.062–1.423; emergency internal/surgical ward OR, 1.451; 95% CI, 1.082–1.945); history of venous puncture in the last week (OR, 1.298, 95% CI 1.130–1.491); insertion site, number of puncture attempts, irritant fluid infusion, daily infusion time, daily infusion volume, and type of sealing liquid were independent predictors of PVC failure. Receiver operating characteristic curve analysis indicated that a logistic regression model constructed using these variables had moderate accuracy for the prediction of PVC failure (area under the curve, 0.781). The Hosmer-Lemeshow goodness of fit test demonstrated that the model was correctly specified (χ2 = 2.514, p = 0.961). Conclusion: This study should raise awareness among healthcare providers of the risk factors for PVC failure. We recommend that healthcare providers use vascular access device selection tools to select a clinically appropriate device and for the timely detection of complications, and have a list of drugs classified as irritants or vesicants so they can monitor patients receiving fluid infusions containing these drugs more frequently.

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