Analysis of risk factors for phlebitis after intravenous catheterization in orthopedic patients and implementation of intervention strategies

To explore the risk factors and intervention strategies for phlebitis after intravenous indwelling needle in orthopedics. A retrospective study was conducted on 156 patients who used intravenous catheters in the Department of Orthopedics, Hengdian Hospital, Dongyang City from December 2021 to December 2023. The patients were divided into an occurrence group and a non-occurrence group according to whether phlebitis occurred in the medical record system. The general demographic and clinical data of the two groups of patients were collected and compared. Logistic regression was used to analyze the influencing factors of phlebitis in patients with intravenous catheters for the difference indicators. At the same time, the nomogram risk prediction graph was drawn according to each factor, and the receiver operating characteristic curve (ROC curve) was drawn to evaluate the value accuracy of the nomogram, and corresponding intervention measures were taken for each factor. There were significant differences in age, nutritional status, indwelling time of the indwelling needle, drug temperature, fluid volume, number of punctures, and puncture location between the two groups (χ2 = 10.21, 11.68, 12.16, 9.07, 7.81, 9.78, and 10.87, all P < 0.05). Collinearity analysis showed that there was a collinearity problem in the fluid volume and puncture location (VIF > 10, tolerance < 0.1), which were removed from the model for logistic regression analysis. Logistic analysis showed that age, nutritional status, indwelling time of the indwelling needle, drug temperature, and number of punctures were independent risk factors for phlebitis after intravenous indwelling needle in orthopedic patients (OR =4.248, 6.079, 5.036, 4.022, and 4.154, all P < 0.05). Based on logistic regression analysis, the prediction graph of the nomogram was constructed and it was found that each factor had a high predictive value. The ROC curve was drawn and the AUC was 0.730. The 95%CI was (0.622-0.837), which proved that the nomogram was of high value. Age, nutritional status, indwelling time of intravenous needle, drug temperature and puncture times are independent factors for the occurrence of phlebitis in patients with intravenous indwelling needles. The above indicators can provide a reference for early clinical prediction and screening of high-risk groups and take relevant measures.