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Central Venous Access Device Complications and Premature Removal in Patients With Haematological Malignancies: A Multi‐Site Cohort Study

Year: 2025

Type: article

Abstract: Background: Patients with haematological malignancies require urgent and reliable venous access for the administration of systemic anticancer therapies (SACTs) commonly via central venous access devices (CVADs). Disease pathophysiology and side effects of SACTs increase the risk of complications during the dwell time and premature removal. CVAD complications are associated with treatment disruption, increased morbidity and mortality. This study aimed to comprehensively describe CVAD performance over a 12-month period in patients with haematological malignancies. Methods: A multi-site cohort study at four tertiary hospitals in Melbourne, Australia was undertaken using multidisciplinary data from patient health records and administrative datasets including patient, device, insertion, maintenance, complication and removal data. Cases of interest were CVADs, ascertained using lists provided by the insertion services. Findings: = 919, 85%) had documented complications during their dwell time and the proportion of premature removals in these CVADs was over two-fold higher than CVADs with no documented complications. Multivariable Cox regression results indicated that CVAD type, urgency of the procedure, concurrent CVADs and insertion technology were associated with an increased risk of premature removal. Clinical variations in insertion and management care throughout the life of a CVAD and current evidence were identified. Conclusion: An unacceptably high proportion of CVADs had complications documented during the dwell time and were prematurely removed. Inconsistencies in current evidence and clinical practice highlight opportunities to positively impact CVAD outcomes in this cohort. Trial Registration: The authors have confirmed clinical trial registration is not needed for this submission.

Source: eJHaem

DOI: 10.1002/jha2.1090

Authors: Kerrie Curtis, Samantha Keogh, Meinir Krishnasamy, Karla Gough