Correlation between smartphone thermographic temperature and visual infusion phlebitis score in surgical patients with peripheral intravenous access at Dr. Hasan Sadikin General Hospital
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Abstract
Phlebitis is a common complication of peripheral intravenous catheter use that increases patient morbidity and length of hospital stay. The Visual Infusion Phlebitis (VIP) score is widely used for clinical assessment but remains subjective and does not incorporate temperature as an inflammatory marker. Smartphone-based infrared thermography offers a potential objective, non-invasive, and practical adjunct parameter. This study aimed to determine the correlation between local temperature measured by smartphone thermography and VIP score in patients with peripheral intravenous access at Dr. Hasan Sadikin General Hospital. An observational analytic study with a cross-sectional design was conducted in 37 patients with catheter dwell time ≥72 hours. Temperature at the infusion site was measured using a smartphone-based thermal camera and compared with the contralateral healthy area, while phlebitis severity was simultaneously assessed using the VIP score. Data were analyzed using the Shapiro–Wilk normality test and Spearman correlation test at a 95% confidence level. The mean VIP score was 1.86 ± 1.38 (range 0–4), and the mean infusion-site temperature was 35.9 ± 1.7°C (range 33.2–38.1°C). A statistically significant, moderate positive correlation was found between VIP score and thermographic temperature (r = 0.52; p = 0.002), indicating that higher VIP scores were associated with increased local temperature, reflecting the underlying inflammatory process. These findings suggest that smartphone-based thermographic imaging may serve as a useful objective adjunct in phlebitis evaluation among patients with peripheral intravenous access, complementing rather than replacing comprehensive clinical assessment.
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How to Cite
Djajakusumah, T. M., Septrina, R., & Pangeran, H. (2026). Correlation between smartphone thermographic temperature and visual infusion phlebitis score in surgical patients with peripheral intravenous access at Dr. Hasan Sadikin General Hospital. International Journal on Health and Medical Sciences, 4(3), 164–172. https://doi.org/10.35335/healmed.v4i3.744
References
Baumeister, S., Kocher, T., Papapanou, P. N., Holtfreter, B., & Demmer, R. T. (2026). Cross‐Sectional Studies: Strengths, Limitations, and Methodological Considerations. Journal of Periodontal Research. https://doi.org/10.1111/jre.70063
Cernuda-Martínez, J. A., Cobo-Sánchez, J. L., Alarcón-Duque, E. M., Moreno-Rubio, E., Suárez-Mier, M. B., del Río-Pisabarro, M. del C., & Ferraz-Torres, M. (2025). Clinical-epidemiological predictors of phlebitis associated with peripheral intravenous catheters in Spanish hospitals: results of a national cohort study. International Journal of Nursing Studies Advances, 9, 100355. https://doi.org/10.1016/j.ijnsa.2025.100355
Cernuda Martínez, J. A., Suárez Mier, M. B., Martínez Ortega, M. del C., Casas Rodríguez, R., Villafranca Renes, C., & Del Río Pisabarro, C. (2024). Risk factors and incidence of peripheral venous catheters-related phlebitis between 2017 and 2021: A multicentre study (Flebitis Zero Project). The Journal of Vascular Access, 25(6), 1835–1841. https://doi.org/10.1177/11297298231189963
Chambers, K., Prittie, J., & Mastrocco, A. (2025). Phlebitis in Veterinary Patients. Journal of Veterinary Emergency and Critical Care, 35(6), 619–636. https://doi.org/10.1111/vec.70061
Chan, H., Joseph, S., Tran, F., Dotel, R., Ngian, V. J. J., & Ong, B. S. (2025). Safety and efficacy of continuous cefazolin infusion via peripheral intravenous catheter (PIVC) for outpatient therapy: a brief report. JAC-Antimicrobial Resistance, 7(5). https://doi.org/10.1093/jacamr/dlaf169
Clark, S., Dunn, G., Moore, T., Jayson, M., King, T. A., & Herrick, A. L. (2003). Comparison of thermography and laser Doppler imaging in the assessment of Raynaud’s phenomenon. Microvascular Research, 66(1), 73–76. https://doi.org/10.1016/S0026-2862(03)00018-9
Doesburg, F., Smit, J. M., Paans, W., Onrust, M., Nijsten, M. W., & Dieperink, W. (2019). Use of infrared thermography in the detection of superficial phlebitis in adult intensive care unit patients: A prospective single-center observational study. PLOS ONE, 14(3), e0213754. https://doi.org/10.1371/journal.pone.0213754
Fitriyanti, S. (2014). Faktor Yang Mempengaruhi Terjadinya Phlebitis di Rumah Sakit Bhayangkara TK II Hs Samsoeri Metojoso Surabaya. UNIVERSITAS AIRLANGGA. https://repository.unair.ac.id/22694/
Furlan, M. da S., Saba, A., & Lima, A. F. C. (2024). Risk factors associated with the occurrence of the adverse event phlebitis in hospitalized adult patients. Revista Brasileira de Enfermagem, 77(5), e20240162. https://doi.org/10.1590/0034-7167-2024-0162
Gahlot, R., Nigam, C., Kumar, V., Yadav, G., Anupurba, S., Gahlot, R., Nigam, C., Kumar, V., Yadav, G., & Anupurba, S. (2014). Catheter-related bloodstream infections. International Journal of Critical Illness and Injury Science, 4(2), 162. https://doi.org/10.4103/2229-5151.134184
Gallant, P., & Schultz, A. A. (2006). Evaluation of a visual infusion phlebitis scale for determining appropriate discontinuation of peripheral intravenous catheters. Journal of Infusion Nursing, 29(6), 338–345.
Gatt, A., Formosa, C., Cassar, K., Camilleri, K. P., De Raffaele, C., Mizzi, A., Azzopardi, C., Mizzi, S., Falzon, O., Cristina, S., & Chockalingam, N. (2015). Thermographic Patterns of the Upper and Lower Limbs: Baseline Data. International Journal of Vascular Medicine, 2015(1), 1–9. https://doi.org/10.1155/2015/831369
Giustivi, D., Celano, R., Cattalani, M., Camilli, C., Trombetta, L., Facchinetti, P., Bartoli, A., Bizzi, E., Urso, F., Donadoni, M., Quici, M., La Cava, L., Calloni, M., Martini, E., Taino, A., Cogliati, C., & Gidaro, A. (2025). Ultrasound assessment of short peripheral catheter failure. The Journal of Vascular Access, 26(4), 1187–1193. https://doi.org/10.1177/11297298241261146
Habibzadeh, F. (2024). Data Distribution: Normal or Abnormal? Journal of Korean Medical Science, 39(3). https://doi.org/10.3346/jkms.2024.39.e35
Henedy, W. M., Alamoudi, F. A., Sallam, S. A. E. G., Shahin, M. A. H., Elmadbouh, G., Elfakhrany, A. T., & Deep, S. H. (2025). A quasi-experimental study on conservative nursing measures for preventing phlebitis in chemotherapy patients. Scientific Reports, 15(1), 45226. https://doi.org/10.1038/s41598-025-29272-z
Indarwati, F., Munday, J., & Keogh, S. (2023). Peripheral intravenous catheter insertion, maintenance and outcomes in Indonesian paediatric hospital settings: A point prevalence study. Journal of Pediatric Nursing, 73, 106–112. https://doi.org/10.1016/j.pedn.2023.08.009
Ji, H., Shi, X., Wang, S., Wang, S., Yan, D., Tong, L., Zhong, Q., Feng, M., Hao, S., Li, W., & Wang, X. (2025). Symptomatic and pathological features in chemical phlebitis rat model by injection vinorelbine via dorsal pedal vein. Scientific Reports, 16(1), 44468. https://doi.org/10.1038/s41598-025-28111-5
John, H. E., Niumsawatt, V., Rozen, W. M., & Whitaker, I. S. (2016). Clinical applications of dynamic infrared thermography in plastic surgery: a systematic review. Gland Surgery, 5(2), 122. https://doi.org/10.3978/j.issn.2227-684X.2015.11.07.
Kaplan, F., Çelik, H., Aslan, H., & Aktura, S. Ç. (2025). Comparison of peripheral intravenous catheterization applied to different anatomical sites in terms of pain, phlebitis and infiltration. BMC Nursing, 24(1), 393. https://doi.org/10.1186/s12912-025-02979-0
Kesztyüs, D., Brucher, S., Wilson, C., & Kesztyüs, T. (2023). Use of Infrared Thermography in Medical Diagnosis, Screening, and Disease Monitoring: A Scoping Review. Medicina, 59(12), 2139. https://doi.org/10.3390/medicina59122139
Osei-Tutu, E., Tuoyire, D. A., Debrah, S., & Ayetey, H. (2022). Peripheral Intravenous Cannulation and Phlebitis Risk at Cape Coast Teaching Hospital. Postgraduate Medical Journal of Ghana, 4(1), 11–18. https://doi.org/10.60014/pmjg.v4i1.79
Pérez-Guerrero, E. E., Guillén-Medina, M. R., Márquez-Sandoval, F., Vera-Cruz, J. M., Gallegos-Arreola, M. P., Rico-Méndez, M. A., Aguilar-Velázquez, J. A., & Gutiérrez-Hurtado, I. A. (2024). Methodological and Statistical Considerations for Cross-Sectional, Case–Control, and Cohort Studies. Journal of Clinical Medicine, 13(14), 4005. https://doi.org/10.3390/jcm13144005
Ray‐Barruel, G., Polit, D. F., Murfield, J. E., & Rickard, C. M. (2014). Infusion phlebitis assessment measures: a systematic review. Journal of Evaluation in Clinical Practice, 20(2), 191–202. https://doi.org/10.1111/jep.12107
Sharma, A., Kumari, S., & Saxena, A. (2023). Commentary on ”Comparative Effectiveness of Robot-Assisted Training Versus Enhanced Upper Extremity Therapy on Upper and Lower Extremity for Stroke Survivors: A Multicentre Randomized Controlled Trial”. Journal of Rehabilitation Medicine, 55, jrm5588. https://doi.org/10.2340/jrm.v55.5588
Simões, A. M. N., Vendramim, P., & Pedreira, M. L. G. (2022). Risk factors for peripheral intravenous catheter-related phlebitis in adult patients. Revista Da Escola de Enfermagem Da USP, 56, e20210398. https://doi.org/10.1590/1980-220x-reeusp-2021-0398en
Simpson, S. E., & Zersen, K. M. (2023). Incidence and type of peripheral intravenous catheter complications documented in hospitalised dogs. Journal of Small Animal Practice, 64(3), 130–135. https://doi.org/10.1111/jsap.13574
Skversky, N. J., Herring, A. B., & Baron, R. C. (1964). Thermography in peripheral vascular diseases. Annals of the New York Academy of Sciences, 121(1), 118–134. https://doi.org/10.1111/j.1749-6632.1964.tb13691.x
Taka, I., Hasalla, E., Sula (Kreci), A., Bahiti, B., Hida, R., & Bani, B. (2025). Risk factors for phlebitis associated with peripheral intravenous catheters: a scoping review of the literature. ACTA MEDICA BALKANICA - International Journal of Medical Sciences, 10(19–20), 175–189. https://doi.org/10.62792/ut.amb.v10.i19-20.p3048
Tzolos, E., & Salawu, A. (2014). Improving the frequency of visual infusion phlebitis (VIP) scoring on an oncology ward. BMJ Quality Improvement Reports, 3(1), u205455.w2364. https://doi.org/10.1136/bmjquality.u205455.w2364
Urbanetto, J. de S., Peixoto, C. G., & May, T. A. (2016). Incidence of phlebitis associated with the use of peripheral IV catheter and following catheter removal. Revista Latino-Americana de Enfermagem, 24, e2746. https://doi.org/10.1590/1518-8345.0604.2746
Ventura, D. R. P., Freitas, J. A. S., & Lindo, J. F. F. (2021). Reliability study of Visual Infusion Phlebitis Score Portuguese European version. https://doi.org/10.21203/rs.3.rs-882728/v1
Wallace, G. A., Singh, N., Quiroga, E., & Tran, N. T. (2018). The Use of Smart Phone Thermal Imaging for Assessment of Peripheral Perfusion in Vascular Patients. Annals of Vascular Surgery, 47, 157–161. https://doi.org/10.1016/j.avsg.2017.07.028
Yasuda, H., Rickard, C. M., Marsh, N., Yamamoto, R., Kotani, Y., Kishihara, Y., Kondo, N., Sekine, K., Shime, N., Morikane, K., & Abe, T. (2022). Risk factors for peripheral intravascular catheter-related phlebitis in critically ill patients: analysis of 3429 catheters from 23 Japanese intensive care units. Annals of Intensive Care, 12(1), 33. https://doi.org/10.1186/s13613-022-01009-5
Cernuda-Martínez, J. A., Cobo-Sánchez, J. L., Alarcón-Duque, E. M., Moreno-Rubio, E., Suárez-Mier, M. B., del Río-Pisabarro, M. del C., & Ferraz-Torres, M. (2025). Clinical-epidemiological predictors of phlebitis associated with peripheral intravenous catheters in Spanish hospitals: results of a national cohort study. International Journal of Nursing Studies Advances, 9, 100355. https://doi.org/10.1016/j.ijnsa.2025.100355
Cernuda Martínez, J. A., Suárez Mier, M. B., Martínez Ortega, M. del C., Casas Rodríguez, R., Villafranca Renes, C., & Del Río Pisabarro, C. (2024). Risk factors and incidence of peripheral venous catheters-related phlebitis between 2017 and 2021: A multicentre study (Flebitis Zero Project). The Journal of Vascular Access, 25(6), 1835–1841. https://doi.org/10.1177/11297298231189963
Chambers, K., Prittie, J., & Mastrocco, A. (2025). Phlebitis in Veterinary Patients. Journal of Veterinary Emergency and Critical Care, 35(6), 619–636. https://doi.org/10.1111/vec.70061
Chan, H., Joseph, S., Tran, F., Dotel, R., Ngian, V. J. J., & Ong, B. S. (2025). Safety and efficacy of continuous cefazolin infusion via peripheral intravenous catheter (PIVC) for outpatient therapy: a brief report. JAC-Antimicrobial Resistance, 7(5). https://doi.org/10.1093/jacamr/dlaf169
Clark, S., Dunn, G., Moore, T., Jayson, M., King, T. A., & Herrick, A. L. (2003). Comparison of thermography and laser Doppler imaging in the assessment of Raynaud’s phenomenon. Microvascular Research, 66(1), 73–76. https://doi.org/10.1016/S0026-2862(03)00018-9
Doesburg, F., Smit, J. M., Paans, W., Onrust, M., Nijsten, M. W., & Dieperink, W. (2019). Use of infrared thermography in the detection of superficial phlebitis in adult intensive care unit patients: A prospective single-center observational study. PLOS ONE, 14(3), e0213754. https://doi.org/10.1371/journal.pone.0213754
Fitriyanti, S. (2014). Faktor Yang Mempengaruhi Terjadinya Phlebitis di Rumah Sakit Bhayangkara TK II Hs Samsoeri Metojoso Surabaya. UNIVERSITAS AIRLANGGA. https://repository.unair.ac.id/22694/
Furlan, M. da S., Saba, A., & Lima, A. F. C. (2024). Risk factors associated with the occurrence of the adverse event phlebitis in hospitalized adult patients. Revista Brasileira de Enfermagem, 77(5), e20240162. https://doi.org/10.1590/0034-7167-2024-0162
Gahlot, R., Nigam, C., Kumar, V., Yadav, G., Anupurba, S., Gahlot, R., Nigam, C., Kumar, V., Yadav, G., & Anupurba, S. (2014). Catheter-related bloodstream infections. International Journal of Critical Illness and Injury Science, 4(2), 162. https://doi.org/10.4103/2229-5151.134184
Gallant, P., & Schultz, A. A. (2006). Evaluation of a visual infusion phlebitis scale for determining appropriate discontinuation of peripheral intravenous catheters. Journal of Infusion Nursing, 29(6), 338–345.
Gatt, A., Formosa, C., Cassar, K., Camilleri, K. P., De Raffaele, C., Mizzi, A., Azzopardi, C., Mizzi, S., Falzon, O., Cristina, S., & Chockalingam, N. (2015). Thermographic Patterns of the Upper and Lower Limbs: Baseline Data. International Journal of Vascular Medicine, 2015(1), 1–9. https://doi.org/10.1155/2015/831369
Giustivi, D., Celano, R., Cattalani, M., Camilli, C., Trombetta, L., Facchinetti, P., Bartoli, A., Bizzi, E., Urso, F., Donadoni, M., Quici, M., La Cava, L., Calloni, M., Martini, E., Taino, A., Cogliati, C., & Gidaro, A. (2025). Ultrasound assessment of short peripheral catheter failure. The Journal of Vascular Access, 26(4), 1187–1193. https://doi.org/10.1177/11297298241261146
Habibzadeh, F. (2024). Data Distribution: Normal or Abnormal? Journal of Korean Medical Science, 39(3). https://doi.org/10.3346/jkms.2024.39.e35
Henedy, W. M., Alamoudi, F. A., Sallam, S. A. E. G., Shahin, M. A. H., Elmadbouh, G., Elfakhrany, A. T., & Deep, S. H. (2025). A quasi-experimental study on conservative nursing measures for preventing phlebitis in chemotherapy patients. Scientific Reports, 15(1), 45226. https://doi.org/10.1038/s41598-025-29272-z
Indarwati, F., Munday, J., & Keogh, S. (2023). Peripheral intravenous catheter insertion, maintenance and outcomes in Indonesian paediatric hospital settings: A point prevalence study. Journal of Pediatric Nursing, 73, 106–112. https://doi.org/10.1016/j.pedn.2023.08.009
Ji, H., Shi, X., Wang, S., Wang, S., Yan, D., Tong, L., Zhong, Q., Feng, M., Hao, S., Li, W., & Wang, X. (2025). Symptomatic and pathological features in chemical phlebitis rat model by injection vinorelbine via dorsal pedal vein. Scientific Reports, 16(1), 44468. https://doi.org/10.1038/s41598-025-28111-5
John, H. E., Niumsawatt, V., Rozen, W. M., & Whitaker, I. S. (2016). Clinical applications of dynamic infrared thermography in plastic surgery: a systematic review. Gland Surgery, 5(2), 122. https://doi.org/10.3978/j.issn.2227-684X.2015.11.07.
Kaplan, F., Çelik, H., Aslan, H., & Aktura, S. Ç. (2025). Comparison of peripheral intravenous catheterization applied to different anatomical sites in terms of pain, phlebitis and infiltration. BMC Nursing, 24(1), 393. https://doi.org/10.1186/s12912-025-02979-0
Kesztyüs, D., Brucher, S., Wilson, C., & Kesztyüs, T. (2023). Use of Infrared Thermography in Medical Diagnosis, Screening, and Disease Monitoring: A Scoping Review. Medicina, 59(12), 2139. https://doi.org/10.3390/medicina59122139
Osei-Tutu, E., Tuoyire, D. A., Debrah, S., & Ayetey, H. (2022). Peripheral Intravenous Cannulation and Phlebitis Risk at Cape Coast Teaching Hospital. Postgraduate Medical Journal of Ghana, 4(1), 11–18. https://doi.org/10.60014/pmjg.v4i1.79
Pérez-Guerrero, E. E., Guillén-Medina, M. R., Márquez-Sandoval, F., Vera-Cruz, J. M., Gallegos-Arreola, M. P., Rico-Méndez, M. A., Aguilar-Velázquez, J. A., & Gutiérrez-Hurtado, I. A. (2024). Methodological and Statistical Considerations for Cross-Sectional, Case–Control, and Cohort Studies. Journal of Clinical Medicine, 13(14), 4005. https://doi.org/10.3390/jcm13144005
Ray‐Barruel, G., Polit, D. F., Murfield, J. E., & Rickard, C. M. (2014). Infusion phlebitis assessment measures: a systematic review. Journal of Evaluation in Clinical Practice, 20(2), 191–202. https://doi.org/10.1111/jep.12107
Sharma, A., Kumari, S., & Saxena, A. (2023). Commentary on ”Comparative Effectiveness of Robot-Assisted Training Versus Enhanced Upper Extremity Therapy on Upper and Lower Extremity for Stroke Survivors: A Multicentre Randomized Controlled Trial”. Journal of Rehabilitation Medicine, 55, jrm5588. https://doi.org/10.2340/jrm.v55.5588
Simões, A. M. N., Vendramim, P., & Pedreira, M. L. G. (2022). Risk factors for peripheral intravenous catheter-related phlebitis in adult patients. Revista Da Escola de Enfermagem Da USP, 56, e20210398. https://doi.org/10.1590/1980-220x-reeusp-2021-0398en
Simpson, S. E., & Zersen, K. M. (2023). Incidence and type of peripheral intravenous catheter complications documented in hospitalised dogs. Journal of Small Animal Practice, 64(3), 130–135. https://doi.org/10.1111/jsap.13574
Skversky, N. J., Herring, A. B., & Baron, R. C. (1964). Thermography in peripheral vascular diseases. Annals of the New York Academy of Sciences, 121(1), 118–134. https://doi.org/10.1111/j.1749-6632.1964.tb13691.x
Taka, I., Hasalla, E., Sula (Kreci), A., Bahiti, B., Hida, R., & Bani, B. (2025). Risk factors for phlebitis associated with peripheral intravenous catheters: a scoping review of the literature. ACTA MEDICA BALKANICA - International Journal of Medical Sciences, 10(19–20), 175–189. https://doi.org/10.62792/ut.amb.v10.i19-20.p3048
Tzolos, E., & Salawu, A. (2014). Improving the frequency of visual infusion phlebitis (VIP) scoring on an oncology ward. BMJ Quality Improvement Reports, 3(1), u205455.w2364. https://doi.org/10.1136/bmjquality.u205455.w2364
Urbanetto, J. de S., Peixoto, C. G., & May, T. A. (2016). Incidence of phlebitis associated with the use of peripheral IV catheter and following catheter removal. Revista Latino-Americana de Enfermagem, 24, e2746. https://doi.org/10.1590/1518-8345.0604.2746
Ventura, D. R. P., Freitas, J. A. S., & Lindo, J. F. F. (2021). Reliability study of Visual Infusion Phlebitis Score Portuguese European version. https://doi.org/10.21203/rs.3.rs-882728/v1
Wallace, G. A., Singh, N., Quiroga, E., & Tran, N. T. (2018). The Use of Smart Phone Thermal Imaging for Assessment of Peripheral Perfusion in Vascular Patients. Annals of Vascular Surgery, 47, 157–161. https://doi.org/10.1016/j.avsg.2017.07.028
Yasuda, H., Rickard, C. M., Marsh, N., Yamamoto, R., Kotani, Y., Kishihara, Y., Kondo, N., Sekine, K., Shime, N., Morikane, K., & Abe, T. (2022). Risk factors for peripheral intravascular catheter-related phlebitis in critically ill patients: analysis of 3429 catheters from 23 Japanese intensive care units. Annals of Intensive Care, 12(1), 33. https://doi.org/10.1186/s13613-022-01009-5
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