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Risk Factors of Nicardipine-Related Phlebitis in Acute Stroke Patients.
- Source :
-
Journal of stroke and cerebrovascular diseases : the official journal of National Stroke Association [J Stroke Cerebrovasc Dis] 2016 Oct; Vol. 25 (10), pp. 2513-8. Date of Electronic Publication: 2016 Jul 14. - Publication Year :
- 2016
-
Abstract
- Background and Purpose: Intravenous nicardipine is generally used to treat hypertension in acute stroke patients but is associated with frequent phlebitis. We aimed to identify the incidence and risk factors of phlebitis in such patients.<br />Methods: The incidence and risk factors of phlebitis were investigated in 358 acute stroke patients from July 2014 to June 2015.<br />Results: In total, 138 patients received intravenous nicardipine. Of 45 (12.6%) phlebitis patients in 358 acute stroke patients, 42 (93.3%) were administered nicardipine, which was significantly associated with phlebitis occurrence (P < .01). Other candidate risk factors of phlebitis of acute stroke patients in univariate analysis were intracerebral hemorrhage (P < .01), nicardipine injection to paralyzed limbs (P = .023), dilution of nicardipine with normal saline (P < .01), higher maximum flow rate of nicardipine (7.2 ± 4.1 mg/h versus 1.6 ± 3.1 mg/h; P < .01), and higher maximum concentration of nicardipine (271.5 ± 145.0 µg/mL versus 37.6 ± 75.0 µg/mL; P < .01). The only statistically significant independent factor following multivariate logistic regression analysis, according to the optimal cutoff values defined from receiver operating characteristic curve analyses, was the maximum concentration of nicardipine greater than 130 µg/mL (OR 57.9; 95% CI 21.5-156; P < .01). A gradual decline of pH below 4.3 was observed when the concentration of nicardipine solution increased to greater than or equal to 130 µg/mL in vitro.<br />Conclusions: Nicardipine-related phlebitis is frequently observed in acute stroke patients and is significantly associated with administration of a maximum concentration of nicardipine greater than 130 µg/mL.<br /> (Copyright © 2016 National Stroke Association. Published by Elsevier Inc. All rights reserved.)
- Subjects :
- Administration, Intravenous
Aged
Aged, 80 and over
Antihypertensive Agents administration & dosage
Dose-Response Relationship, Drug
Female
Humans
Hypertension diagnosis
Hypertension epidemiology
Incidence
Japan epidemiology
Logistic Models
Male
Middle Aged
Multivariate Analysis
Nicardipine administration & dosage
Odds Ratio
Phlebitis diagnosis
Phlebitis epidemiology
Retrospective Studies
Risk Factors
Stroke diagnosis
Time Factors
Treatment Outcome
Antihypertensive Agents adverse effects
Hypertension drug therapy
Nicardipine adverse effects
Phlebitis chemically induced
Stroke epidemiology
Subjects
Details
- Language :
- English
- ISSN :
- 1532-8511
- Volume :
- 25
- Issue :
- 10
- Database :
- MEDLINE
- Journal :
- Journal of stroke and cerebrovascular diseases : the official journal of National Stroke Association
- Publication Type :
- Academic Journal
- Accession number :
- 27423368
- Full Text :
- https://doi.org/10.1016/j.jstrokecerebrovasdis.2016.06.028