Time to occurrence and predictors of peripheral intravenous cannula-induced complications among pediatrics patients in Debre Birhan City public hospitals, Ethiopia, 2025

Abstract

BACKGROUND: Peripheral intravenous cannulation is a common but complication-prone procedure in pediatric care. In Ethiopia, however, there is a critical lack of evidence on the timing and predictors of these complications, hindering the development of effective local preventive strategies. OBJECTIVE: To assess time to occurrence and predictors of peripheral intravenous cannula -induced complications among pediatric patients in Debre Birhan city public hospitals, Ethiopia, 2025. METHOD: An institutional-based prospective cohort study was conducted at Debre Birhan public hospitals from March 1 to May 20, 2025. Participants were selected using a systematic random sampling technique (K = 2). The data were collected with Kobo Toolbox and analyzed using Stata-17. Descriptive statistics and Cox regression were fitted. The Cox proportional hazards assumptions were checked both graphically and statistically. Variables with p < 0.25 in bivariable cox regration were included in the multivariable Cox model. The strength of statistical association was assessed by adjusted hazard ratios and respective 95% confidence intervals. RESULT: Of the 584 pediatric patients included, 35.8% (95% CI 32% - 40%) developed peripheral intravenous cannula-induced complications. The median time to develop these complications was 108 h (95% CI: 96-108). Parental education (unable to read and write) (AHR = 2.80, 95% CI: 1.70, 4.90, p < 0.001), no mask use during insertion (AHR = 2.3, 95% CI: 1.70, 3.09, p < 0.001), performing the procedure without insertion set kit (AHR = 4.34, 95% CI: 2.10, 8.93, p < 0.001), right side of cannulation (AHR = 1.96, 95% CI: 1.40, 2.72, p < 0.001), inappropriate cannula dressing (AHR = 1.45, 95% CI: 1.02, 2.37, p = 0.025) and blood administration (AHR = 1.54, 95% CI: 1.09, 2.15, p = 0.014) were predictors of time to occurrence of peripheral intravenous cannula induced complications. CONCLUSION: Peripheral intravenous cannula induced complications tend to occur after a relatively prolonged dwell time. Parental education, mask use, insertion set kit, side of cannulation, cannula dressing, and blood administration were predictors for these complications. Therefore, targeted interventions like ensuring mask use, insertion kits, and proper dressing practices may reduce complications and improve pediatric outcomes.