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Master Thesis

Étude VENSCORE : création d’un score prédictif et identification des facteurs de risque d’échec de pose de voie veineuse périphérique chez l’adulte en préopératoire

Abstract : Background: peripheral intravenous cannula (PIVC) insertions are frequently performed by anesthesia providers. Failure rate at the first attempt is between 17 and 49.1% in the perioperative setting. Our primary objective was to develop a scale named VENSCORE to predict preoperative PIVC insertion failure at the first attempt in the adult population. Methods: this prospective, observational, multicenter study was conducted from June 2016 to June 2018 in 14 hospitals. Following ethical committee approval and patient oral consent, all consecutive adult patients were included upon arrival in the operating room. Data, based on 48 variables, were collected after patient enrollment. Univariate then multivariate analysis by logistic regression were performed. The 95% confidence interval of the area under the curve (AUC) of the predictive model was calculated using the bootstrapping method. VENSCORE was derived from the multivariate analysis. Results: 3394 patients were included, and 27 were excluded because of protocol violation. PIVC insertion failure rate at the first attempt was 20.3%. After multivariate analysis, history of difficult PIVC insertion, high-risk surgery, poor vein visibility and, moderate or poor vein palpability were identified as risk factors. AUC of the corrected predictive model was 0.82 [IC 95%:0,80;0,84]. VENSCORE ranged from 0 to 6 and was associated with failure rate from 7% to 97%, respectively. Conclusion: VENSCORE, based on four items, is a new predictive scale to predict preoperative failure rate at the first PIVC insertion attempt in the adult population. It can be a tool for practitioners to identify high-risk patients and optimize their technique.
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https://dumas.ccsd.cnrs.fr/dumas-02419457
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Submitted on : Thursday, December 19, 2019 - 2:50:30 PM
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  • HAL Id : dumas-02419457, version 1

Citation

Émeline Angles. Étude VENSCORE : création d’un score prédictif et identification des facteurs de risque d’échec de pose de voie veineuse périphérique chez l’adulte en préopératoire. Sciences du Vivant [q-bio]. 2019. ⟨dumas-02419457⟩

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