Incidence and Risk Factors for Accidental Removal of Medical Devices in an Intensive Care Unit: A Retrospective Cohort.

BACKGROUND

Accidental removal of medical devices (ARMD) is an important safety risk for critically ill patients admitted to an intensive care unit (ICU), and little is known about the risk factors for its occurrence.

OBJECTIVE

To estimate the incidence and investigate risk factors for ARMD among adult patients admitted to the ICU.

METHODS

This is a retrospective cohort study including data from adult patients admitted to the ICU between 2018 and 2021. The study was carried out in the adult ICU of a hospital accredited by the Joint Commission International, consisting of 54 beds.

RESULTS

A total of 5880 medical records of patients admitted to the ICU were included. Of these, 376 (6.4%) were affected by ARMD; the majority were male (256 [68.1%]), with a mean age of 68.2 (18.9) years. The nasoenteral catheter was the most frequently removed device (44.4%), followed by the central venous catheter (11.4%), the indwelling bladder catheter (9.0%), and the peripheral venous catheter (6.9%). The logistic regression model showed that the diagnosis of kidney disease (odds ratio [OR], 4.09; 95% confidence interval [CI], 1.34-12.44), occurrence of delirium (OR, 2.02; 95% CI, 1.35-3.03), and length of stay in the ICU (OR, 1.02; 95% CI, 1.01-1.02) increased the chance of ARMD occurrence. Patients requiring vasopressor medications had a lower chance of ARMD (OR, 0.32; 95% CI, 0.22-0.46).

CONCLUSIONS

The incidence rate of ARMD is similar to those reported in previous studies. However, the results pointed to new risk factors for the occurrence of ARMD, such as chronic kidney disease and length of stay in the ICU.