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Background <p>Mini-midline catheters are commonly used for intermediate-duration vascular access in neurosurgical patients, yet the optimal insertion site (forearm vs. upper arm) remains undefined. The aim of this study was to compare clinical effects, safety, and cost between forearm and upper arm mini-midline catheter placement in neurosurgical patients.</p> Methods <p>This prospective, non-randomized controlled observational study included 168 neurosurgical patients admitted to a tertiary general hospital between March 2024 and October 2025. All patients received ultrasound-guided mini-midline catheter placement. The insertion site (forearm: 74 patients; upper arm: 94 patients) was determined jointly by the patient and the attending nurse after standardized information disclosure and discussion. After 1:1 propensity score matching (PSM), 48 patients from each group were included in the final analysis. Outcomes included puncture-related indicators, post-puncture complications, catheter removal rate due to catheter-related complications, indwelling duration, comfort, time to first complication, and economic cost.</p> Results <p>After PSM, no significant differences were observed between the upper arm and forearm groups in first-attempt puncture success rate (87.50% vs. 75.00%), total catheterization time [17.00 (15.00, 18.00) vs. 16.00 (14.00, 25.50) min], catheter-related comfort score [101.50 (74.25, 104.00) vs. 95.00 (65.50, 105.00) points], or total catheter-related economic cost (646.36 ± 39.36 vs. 658.85 ± 54.10 yuan) (all <i>P</i> &gt; 0.05). Significant differences (<i>P</i> &lt; 0.05) were found between the upper arm and forearm groups in puncture-related pain score [5.00 (4.00, 6.00) vs. 5.50 (4.00, 7.00) points], post-puncture catheter-related complication rates (50.00% vs. 72.92%), phlebitis incidence (33.33% vs. 56.25%), catheter removal rate due to post-puncture catheter-related complications (25.00% vs. 45.83%), indwelling catheter duration [7.50 (6.00, 12.00) vs. 6.00 (4.00, 6.75) days] and the time to first occurrence of post-puncture catheter-related complications [7.00 (6.00, 11.00) vs. 5.00 (3.00, 6.00) days] (all <i>P</i> &lt; 0.05).</p> Conclusion <p>This propensity score-matched study provides preliminary evidence that upper arm placement may offer advantages over forearm placement for mini-midline catheters in neurosurgical patients. However, given the non-randomized design, these findings are hypothesis-generating and require confirmation in randomized controlled trials with larger sample sizes.</p> Clinical trial number <p>Not applicable.</p>

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Comparison of the effects of mini-midline catheter placement in the forearm versus upper arm of neurosurgical patients based on propensity score matching

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年4月28日

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  • Bingbing Hu,
  • Beibei Wang,
  • Fanglin Li,
  • Na Yang,
  • Jiangying Han,
  • Liangliang Sun

摘要

Background

Mini-midline catheters are commonly used for intermediate-duration vascular access in neurosurgical patients, yet the optimal insertion site (forearm vs. upper arm) remains undefined. The aim of this study was to compare clinical effects, safety, and cost between forearm and upper arm mini-midline catheter placement in neurosurgical patients.

Methods

This prospective, non-randomized controlled observational study included 168 neurosurgical patients admitted to a tertiary general hospital between March 2024 and October 2025. All patients received ultrasound-guided mini-midline catheter placement. The insertion site (forearm: 74 patients; upper arm: 94 patients) was determined jointly by the patient and the attending nurse after standardized information disclosure and discussion. After 1:1 propensity score matching (PSM), 48 patients from each group were included in the final analysis. Outcomes included puncture-related indicators, post-puncture complications, catheter removal rate due to catheter-related complications, indwelling duration, comfort, time to first complication, and economic cost.

Results

After PSM, no significant differences were observed between the upper arm and forearm groups in first-attempt puncture success rate (87.50% vs. 75.00%), total catheterization time [17.00 (15.00, 18.00) vs. 16.00 (14.00, 25.50) min], catheter-related comfort score [101.50 (74.25, 104.00) vs. 95.00 (65.50, 105.00) points], or total catheter-related economic cost (646.36 ± 39.36 vs. 658.85 ± 54.10 yuan) (all P > 0.05). Significant differences (P < 0.05) were found between the upper arm and forearm groups in puncture-related pain score [5.00 (4.00, 6.00) vs. 5.50 (4.00, 7.00) points], post-puncture catheter-related complication rates (50.00% vs. 72.92%), phlebitis incidence (33.33% vs. 56.25%), catheter removal rate due to post-puncture catheter-related complications (25.00% vs. 45.83%), indwelling catheter duration [7.50 (6.00, 12.00) vs. 6.00 (4.00, 6.75) days] and the time to first occurrence of post-puncture catheter-related complications [7.00 (6.00, 11.00) vs. 5.00 (3.00, 6.00) days] (all P < 0.05).

Conclusion

This propensity score-matched study provides preliminary evidence that upper arm placement may offer advantages over forearm placement for mini-midline catheters in neurosurgical patients. However, given the non-randomized design, these findings are hypothesis-generating and require confirmation in randomized controlled trials with larger sample sizes.

Clinical trial number

Not applicable.