Concordancia Interevaluadores de la clasificación de flebitis, sus signos y síntomas en catéteres intravenosos periféricos
Resumen
Introducción: A pesar de que en la literatura se han descrito diversas herramientas para evaluar la presencia y la gravedad de las complicaciones de los CVP, aún se carece de guías estandarizadas y se requiere mayor investigación.
Objetivo: determinar la concordancia inter-evaluadores de la clasificación de flebitis, sus signos y síntomas utilizando la Visual Infusion Phlebitis Scale.
Material y Métodos: Estudio de cohorte prospectiva en pacientes mayores de 18 años hospitalizados en un servicio de urgencias, con el primer catéter venoso periférico instalado. Los signos y síntomas de la flebitis fueron evaluados diariamente mediante la escala. Se realizó un análisis descriptivo y se calculó la concordancia de la clasificación de flebitis, sus signos y síntomas por medio del coeficiente Kappa de Cohen.
Resultados: 817 pacientes fueron incluidos. El signo o síntoma más frecuente fue el eritema (13.59%), seguido de dolor (11.50%), edema (2.99%) e induración (2.02%), no se presentó cordón venoso palpable ni pirexia. La incidencia general de flebitis fue de 11.44%; grado II (9.42%) y grado III (2.02%). El coeficiente de Kappa de Cohen fue de 0.990 (IC 95% 0.982 - 0.996) de la clasificación general de flebitis. La mayor reproducibilidad para los signos y síntomas fue la del dolor (k=0.946) seguido de induración (k=0.894), edema (k=0.716) y eritema (k=0.649).
Conclusiones: Este estudio evidenció una alta concordancia inter-evaluadores en general de la escala y una concordancia entre buena y muy buena para cada uno de signos y síntomas.
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1. Ozger HS, Yasar M, Başyurt R, Bucak F, Dizbay M. Evaluation of the risk factors on time to phlebitis- and nonphlebitis-related failure when peripheral venous catheters were replaced as clinically indicated. The Journal of Vascular Access. 2021;22(1): 69–74. https://doi.org/10.1177/1129729820924553
2. Marsh N, Larsen EN, Ullman AJ, Mihala G, Cooke M, Chopra V, et al. Peripheral intravenous catheter infection and failure: A systematic review and meta-analysis. International Journal of Nursing Studies. 2024;151: 104673. https://doi.org/10.1016/j.ijnurstu.2023.104673
3. Piekiełko P, Mucha A, Stawowczyk E, Wójkowska-Mach J. Peripheral Intravenous Therapy in Internal Medicine Department—Antibiotics and Other Drugs’ Consumption and Characteristics of Vascular Access Devices in 2-Year Observation Study. Antibiotics. 2024;13(7): 664. https://doi.org/10.3390/antibiotics13070664
4. Larsen EN, Marsh N, O’Brien C, Monteagle E, Friese C, Rickard CM. Inherent and modifiable risk factors for peripheral venous catheter failure during cancer treatment: a prospective cohort study. Supportive care in cancer: official journal of the Multinational Association of Supportive Care in Cancer. 2021;29(3): 1487–1496. https://doi.org/10.1007/s00520-020-05643-2
5. Chen Y mei, Fan X wen, Liu M hong, Wang J, Yang Y qun, Su Y fang. Risk factors for peripheral venous catheter failure: A prospective cohort study of 5345 patients. The Journal of Vascular Access. 2022;23(6): 911–921. https://doi.org/10.1177/11297298211015035
6. Marsh N, Larsen EN, Takashima M, Kleidon T, Keogh S, Ullman AJ, et al. Peripheral intravenous catheter failure: A secondary analysis of risks from 11,830 catheters. International Journal of Nursing Studies. 2021;124: 104095. https://doi.org/10.1016/j.ijnurstu.2021.104095
7. Garcia-Expósito J, Sánchez-Meca J, Almenta-Saavedra JA, Llubes-Arrià L, Torné-Ruiz A, Roca J. Peripheral venous catheter-related phlebitis: A meta-analysis of topical treatment. Nursing Open. 2023;10(3): 1270–1280. https://doi.org/10.1002/nop2.1449
8. Vendramim P, Avelar AFM, Rickard CM, Pedreira M d. LG. The RESPECT trial–Replacement of peripheral intravenous catheters according to clinical reasons or every 96 hours: A randomized, controlled, non-inferiority trial. International Journal of Nursing Studies. 2020;107: 103504. https://doi.org/10.1016/j.ijnurstu.2019.103504
9. Shimoni Z, Houdhoud N, Isaacs Y, Froom P. Observational study of peripheral intravenous catheter outcomes in an internal medicine department. Internal Medicine Journal. 2023;53(2): 221–227. https://doi.org/10.1111/imj.15963
10.Simões AMN, Vendramim P, Pedreira MLG. Risk factors for peripheral intravenous catheter-related phlebitis in adult patients. Revista da Escola de Enfermagem da USP. 2022;56: e20210398. https://doi.org/10.1590/1980-220X-REEUSP-2021-0398en
11. Liu C, Chen L, Kong D, Lyu F, Luan L, Yang L. Incidence, risk factors and medical cost of peripheral intravenous catheter-related complications in hospitalised adult patients. The Journal of Vascular Access. 2022;23(1): 57–66. https://doi.org/10.1177/1129729820978124
12. Lulie M, Tadesse A, Tsegaye T, Yesuf T, Silamsaw M. Incidence of peripheral intravenous catheter phlebitis and its associated factors among patients admitted to University of Gondar hospital, Northwest Ethiopia: a prospective, observational study. Thrombosis Journal. 2021;19(1): 48. https://doi.org/10.1186/s12959-021-00301-x
13. Bashir N, Tanveer H. Incidence and associated risk factors of phlebitis among patients with peripheral intravenous cannula. EPH - International Journal of Medical and Health Science ISSN (Online): 2208-2204. 2024;10(03): 39;45. https://eijmhs.com/index.php/mhs/article/view/239/318
14. Bayeh TL, Birhie AY, Alene EM. Time to Develop Phlebitis and Its Predictors Among Patients with Peripheral Intravenous Cannula at Public Hospitals of Bahir Dar City, Amhara, Ethiopia, 2022: A Prospective Observational Study. Nursing: Research and Reviews. 2023;13: 51–60. https://doi.org/10.2147/NRR.S414331
15. Lv L, Zhang J. The incidence and risk of infusion phlebitis with peripheral intravenous catheters: A meta-analysis. The Journal of Vascular Access. 2020;21(3): 342–349. https://doi.org/10.1177/1129729819877323
16. Cernuda-Martínez JA, Cobo-Sánchez JL, Alarcón-Duque EM, Moreno-Rubio E, Suárez-Mier MB, Del Río-Pisabarro MDC, et al. Clinical-epidemiological predictors of phlebitis associated with peripheral intravenous catheters in Spanish hospitals: results of a national cohort study. International Journal of Nursing Studies Advances. 2025;9: 100355. https://doi.org/10.1016/j.ijnsa.2025.100355
17. Silva-dos Santos T, Candido-Anacleto J, Spinazola-Cesar V, Bressani-Lino RL, de Assunção-Lino A, Garbuio DC, et al. Incidencia de flebitis y factores relacionados en el acceso venoso periférico en adultos. Enfermería Global. 2024;23(74): 26–58. https://doi.org/10.6018/eglobal.587911
18. Khalid Mahmood Mahmood A, Cihan Erdogan B. Peripheral intravenous catheter related phlebitis: A point prevalence study in Iraq. The Journal of Vascular Access. 2025; 11297298251330946. https://doi.org/10.1177/11297298251330946
19. Chen Y mei, Fan X wen, Liu M hong, Wang J, Yang Y qun, Su Y fang. Risk factors for peripheral venous catheter failure: A prospective cohort study of 5345 patients. The Journal of Vascular Access. 2022;23(6): 911–921. https://doi.org/10.1177/11297298211015035
20. Yasuda H, Rickard CM, Marsh N, Yamamoto R, Kotani Y, Kishihara Y, et al. Risk factors for peripheral intravascular catheter-related phlebitis in critically ill patients: analysis of 3429 catheters from 23 Japanese intensive care units. Annals of Intensive Care. 2022;12(1): 33. https://doi.org/10.1186/s13613-022-01009-5
21. Fan XW, Xu L, Wei WS, Chen YM, Yang YQ. Relationship between indwelling site and peripheral venous catheter-related complications in adult hospitalized patients: A systematic review and meta-analysis. Journal of Clinical Nursing. 2023;32(7–8): 1014–1024. https://doi.org/10.1111/jocn.16241
22. Kaplan F, Çelik H, Aslan H, Aktura SÇ. Comparison of peripheral intravenous catheterization applied to different anatomical sites in terms of pain, phlebitis and infiltration. BMC Nursing. 2025;24(1): 393. https://doi.org/10.1186/s12912-025-02979-0
23. Harris V, Hughes M, Roberts R, Dolan G, Williams EM. The Development and Testing of a Chemotherapy-Induced Phlebitis Severity (CIPS) Scale for Patients Receiving Anthracycline Chemotherapy for Breast Cancer. Journal of Clinical Medicine. 2020;9(3): 701. https://doi.org/10.3390/jcm9030701
24. Brørs G, Gjeilo KH, Lund T, Skevik K, Aa E, Høvik LH, et al. Amiodarone-induced phlebitis: incidence and adherence to a clinical practice guideline. European Journal of Cardiovascular Nursing. 2023;22(8): 824–831. https://doi.org/10.1093/eurjcn/zvad003
25. Lulie M, Tadesse A, Tsegaye T, Yesuf T, Silamsaw M. Incidence of peripheral intravenous catheter phlebitis and its associated factors among patients admitted to University of Gondar hospital, Northwest Ethiopia: a prospective, observational study. Thrombosis Journal. 2021;19(1): 48. https://doi.org/10.1186/s12959-021-00301-x
26. Larsen EN, Marsh N, Mihala G, King M, Zunk M, Ullman AJ, et al. Intravenous antimicrobial administration through peripheral venous catheters - establishing risk profiles from an analysis of 5252 devices. International Journal of Antimicrobial Agents. 2022;59(4): 106552. https://doi.org/10.1016/j.ijantimicag.2022.106552
27.Simões AMN, Vendramim P, Pedreira MLG. Risk factors for peripheral intravenous catheter-related phlebitis in adult patients. Revista Da Escola De Enfermagem Da U S P. 2022;56: e20210398. https://doi.org/10.1590/1980-220X-REEUSP-2021-0398en
28. Marsh N, Webster J, Ullman AJ, Mihala G, Cooke M, Chopra V, et al. Peripheral intravenous catheter non-infectious complications in adults: A systematic review and meta-analysis. Journal of Advanced Nursing. 2020;76(12): 3346–3362. https://doi.org/10.1111/jan.14565
29. Mihala G, Ray-Barruel G, Chopra V, Webster J, Wallis M, Marsh N, et al. Phlebitis Signs and Symptoms With Peripheral Intravenous Catheters: Incidence and Correlation Study. Journal of Infusion Nursing: The Official Publication of the Infusion Nurses Society. 2018;41(4): 260–263. https://doi.org/10.1097/NAN.0000000000000288
30. Indriani R, Mediani HS. Effect of the Phlebitis Assessment Scale on the Incidence of Phlebitis Rate on Peripheral Infusion: A Systematic Review. Asian Community Health Nursing Research. 2021; 8–8. https://doi.org/10.29253/achnr.2021.3740
31. Torné-Ruiz A, Reguant M, Sanromà-Ortiz M, Piriz M, Roca J, García-Expósito J. Assessment, Treatment, and Follow-Up of Phlebitis Related to Peripheral Venous Catheterisation: A Delphi Study in Spain. Healthcare (Basel, Switzerland). 2024;12(3): 378. https://doi.org/10.3390/healthcare12030378
32. Nickel B, Gorski L, Kleidon T, Kyes A, DeVries M, Keogh S, et al. Infusion Therapy Standards of Practice, 9th Edition. Journal of Infusion Nursing: The Official Publication of the Infusion Nurses Society. 2024;47(1S Suppl 1): S1–S285. https://doi.org/10.1097/NAN.0000000000000532
33. Jørgensen R, Laursen CB, Konge L, Pietersen PI. Education in the placement of ultrasound-guided peripheral venous catheters: a systematic review. Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine. 2021;29: 83. https://doi.org/10.1186/s13049-021-00897-z
34. Ventura D, DaSilva Freitas J, Simoes J. Inclusion of the European Portuguese Version of the Visual Infusion Phlebitis Scale in a Health Information System | HIMSS. Online Journal of Nursing Informatics (OJNI):26 (3). [Accessed 19th September 2025] https://legacy.himss.org/resources/inclusion-european-portuguese-version-visual-infusion-phlebitis-scale-health-information
35. Kuş B, Büyükyılmaz F. Görsel İnfüzyon Flebit Tanılama Skalası: Bağımsız Gözlemciler Arası Uyum Çalışması. Florence Nightingale Journal of Nursing. 2018;26(3): 179–186. https://dergipark.org.tr/tr/pub/fnjn/issue/39968/296258
36. Marimuthu M, Muniasmy M, Barathiraja B, Venkatesh V. Visual Infusion Phlebitis (VIP) score for assessing venflon-related complications: a prospective observational study. International Journal of Advanced Research. 2024;12(12): 1239–1242. https://doi.org/10.21474/IJAR01/20134
37. O’Donnell C, Fardanesh A, Bakare O, Spiteri A, Dewan L, Rohatgi A. 544 The VIP QIP - Reducing the Rate of Inpatient Phlebitis. BJS. 2024;111(Supplement_6): znae163.244. https://doi.org/10.1093/bjs/znae163.244
38. Marsh N, Mihala G, Ray‐Barruel G, Webster J, Wallis MC, Rickard CM. Inter‐rater agreement on PIVC ‐associated phlebitis signs, symptoms and scales. Journal of Evaluation in Clinical Practice. 2015;21(5): 893–899. https://doi.org/10.1111/jep.12396
39. Walker RM, Pires MPO, Ray-Barruel G, Cooke M, Mihala G, Azevedo SS, et al. Peripheral vascular catheter use in Latin America (the vascular study): A multinational cross-sectional study. Frontiers in Medicine. 2023;9: 1039232. https://doi.org/10.3389/fmed.2022.1039232
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