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Peripheral intravenous catheters are an essential medical device which are prone to complications and failure. Identify patient, provider and device risk factors associated with all-cause peripheral intravenous catheter failure as well as individual complications: phlebitis, infiltration/occlusion, and dislodgement to improve patient outcomes. Secondary analysis of twelve prospective studies performed between 2008 and 2020. Australian metropolitan and regional hospitals including one paediatric hospital. Participants were from medical, surgical, haematology, and oncology units. Multilevel mixed-effects parametric survival regression was used to identify factors associated with all-cause peripheral intravenous catheter failure, phlebitis, occlusion/infiltration, and dislodgement. We studied patient (e.g., age, gender), device (e.g., gauge), and provider (e.g., inserting clinician) variables. Stepwise regression involved clinically and p <0.20 significant variables entered into the multivariable model. Results were expressed as hazard ratios (HRs) and 95% confidence intervals (CI); p <0.01 was considered statistically significant. Of 11,830 peripheral intravenous catheters (8,200 participants) failure occurred in 36% (n = 4,263). Occlusion/infiltration incidence was 23% (n = 2,767), phlebitis 12% (n = 1,421), and dislodgement 7% (n = 779) of catheters. Patient factors significantly associated with failure and complications were: female gender (phlebitis; (HR 1.98, 95% CI 1.72–2.27), (infiltration/occlusion; HR 1.45, 95% CI 1.33–1.58), (failure; HR 1.36, 95% CI 1.26–1.46); and each year increase in age (phlebitis; 0.99 HR, 95% CI 0.98–0.99), (failure; 0.99 HR, 95% CI 0.99–0.99). The strongest provider risk factor was intravenous antibiotics (infiltration/occlusion; HR 1.40, 95% CI 1.27–1.53), (phlebitis; HR 1.36, 95% CI 1.18–1.56), (failure; HR 1.26, 95% CI 1.17–1.36). Catheters inserted by vascular access teams were less likely to dislodge (HR 0.53, 95% CI 0.42–0.67). Device risk factors most associated with all-cause failure were wrist/hand (HR 1.34, 95% CI 1.23–1.46), antecubital fossa peripheral intravenous catheters (HR 1.29, 95% CI 1.16–1.44) and 22/24 gauge (HR 1.27, 95% CI 1.12–1.45) catheters. Factors identified, including the protective aspect of vascular access team insertion, and high catheter failure associated with intravenous antibiotic administration, will allow targeted updates of peripheral intravenous catheter guidelines and models of care. [ABSTRACT FROM AUTHOR]

Introduction: People who inject drugs (PWID) commonly experience harms related to their injecting, many of which are consequences of modifiable drug use practices. There is currently a gap in our understanding of how certain injecting-related injuries and diseases (IRID) cluster together, and socio-demographic and drug use characteristics associated with more complex clinical profiles.Method: Surveys were conducted with 902 Australian PWID in 2019. Participants provided information regarding their drug use, and past month experience of the following IRID: artery injection, nerve damage, skin and soft tissue infection, thrombophlebitis, deep vein thrombosis, endocarditis, septic arthritis, osteomyelitis, and septicaemia. We performed a latent class analysis, grouping participants based on reported IRID and ran a class-weighted regression analysis to determine variables associated with class-membership.Results: One-third (34 %) of the sample reported any IRID. A 3-class model identified: 1) no IRID (73 %), moderate IRID (21 %), and 3) high IRID (6%) clusters. Re-using one`s own needles was associated with belonging to the high IRID versus moderate IRID class (ARRR = 2.38; 95 % CI = 1.04-5.48). Other factors, including daily injecting and past 6-month mental health problems were associated with belonging to moderate and high IRID classes versus no IRID class.Conclusion: A meaningful proportion of PWID reported highly complex IRID presentations distinguished by the presence of thrombophlebitis and associated with greater re-use of needles. Increasing needle and syringe coverage remains critical in addressing the harms associated with injecting drug use and expanding the capacity of low-threshold services to address less severe presentations might aid in reducing IRID amongst PWID. [ABSTRACT FROM AUTHOR]