Retrospective Analysis of Extravasation Events at Noordwest Ziekenhuisgroep: Drug Involvement and Patient Impact

Abstract

Extravasation is a potential complication of intravenous therapy that can cause severe tissue damage and long-term consequences. The primary aim of this study was to determine the incidence, patient demographics, and medications associated with extravasation incidents at the NorthWest clinics in 2023. This study also aimed to develop a comprehensive search strategy using CTcue to accurately identify extravasation cases and analyse potential differences in neonatal extravasation rates between 2018-2019 and 2022-2023. The study included all patients who experienced extravasation in 2023 and received intravenous therapy. Patients who did not have a documented extravasation in 2023 or who objected to the use of their data were excluded. A comprehensive search strategy was developed to accurately identify extravasation incidents, including variations of the term "extravasation" to maximize search results. Data was collected using the CTcue AI-assisted text-mining tool, which analysed electronic health records (EHR) from the NorthWest clinics. This tool helped extract both structured and unstructured data to identify relevant extravasation cases. The CTcue search query identified 1,002 potential extravasation cases, with 907 patients confirmed after manual exclusion of those not meeting the criteria. This represents an incidence rate of 2.2% among the 40,505 patients treated with intravenous therapy at NorthWest Clinics in 2023. The total number of extravasation cases in 2023 was 978. All results except gender were discussed in the context of this total number. The most commonly extravasated medications were antibiotics (19.2%) and NaCl 0.9% (10.9%). The secondary objective involved comparing neonatal extravasation rates between 2018-2019 and 2022-2023, with no significant differences found (p=0.281), likely due to the small population size. This study provides critical insights into the incidence and characteristics of extravasations at NorthWest Clinics. The use of CTcue proved highly effective, achieving a 91% true positive rate. Despite some limitations, such as missing data and potential information bias, the study lays a foundation for further research into risk factors and preventive measures. Recommendations include improved documentation practices, targeted staff training, and the use of I.V. watch devices, especially in neonatology, to detect extravasations early and reduce their incidence and impact. Future research should incorporate control patients and use relative figures to provide a more accurate analysis of risk factors.