{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,22]],"date-time":"2026-10-22T00:43:33Z","timestamp":1792629813474,"version":"4.5.0"},"reference-count":39,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2025,3,25]],"date-time":"2025-03-25T00:00:00Z","timestamp":1742860800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["eJHaem"],"published-print":{"date-parts":[[2025,4]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>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\u2010month period in patients with haematological malignancies.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A multi\u2010site 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.<\/jats:p><\/jats:sec><jats:sec><jats:title>Findings<\/jats:title><jats:p>A total of 1078 CVADs were inserted in 673 patients between 1 September 2020 and 31 August 2021. Of the 1078 CVADs, 197 (18%) remained in situ, and 881 (82%) were removed, of which 369 (42%) were removed prematurely due to infection (<jats:italic>n<\/jats:italic>\u00a0=\u00a0208, 57%) and non\u2010infection related reasons (<jats:italic>n<\/jats:italic>\u00a0=\u00a0201, 54%). Most CVADs (<jats:italic>n<\/jats:italic>\u00a0=\u00a0919, 85%) had documented complications during their dwell time and the proportion of premature removals in these CVADs was over two\u2010fold 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.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>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.<\/jats:p><\/jats:sec><jats:sec><jats:title>Trial Registration<\/jats:title><jats:p>The authors have confirmed clinical trial registration is not needed for this submission.<\/jats:p><\/jats:sec>","DOI":"10.1002\/jha2.1090","type":"journal-article","created":{"date-parts":[[2025,3,28]],"date-time":"2025-03-28T00:39:12Z","timestamp":1743122352000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Central Venous Access Device Complications and Premature Removal in Patients With Haematological Malignancies: A Multi\u2010Site Cohort Study"],"prefix":"10.1002","volume":"6","author":[{"ORCID":"https:\/\/orcid.org\/0009-0005-0355-0643","authenticated-orcid":false,"given":"Kerrie","family":"Curtis","sequence":"first","affiliation":[{"name":"Department of Nursing University of Melbourne  Melbourne Victoria Australia"},{"name":"Peter MacCallum Cancer Centre  Melbourne Victoria Australia"},{"name":"Austin Health  Melbourne Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2797-4388","authenticated-orcid":false,"given":"Samantha","family":"Keogh","sequence":"additional","affiliation":[{"name":"Queensland University of Technology  Brisbane Queensland Australia"},{"name":"Royal Brisbane and Women's Hospital  Brisbane Queensland Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3050-4213","authenticated-orcid":false,"given":"Meinir","family":"Krishnasamy","sequence":"additional","affiliation":[{"name":"Department of Nursing University of Melbourne  Melbourne Victoria Australia"},{"name":"Centre for Health Services Research Peter MacCallum Cancer Centre  Melbourne Victoria Australia"},{"name":"Sir Peter MacCallum Department of Oncology University of Melbourne  Melbourne Victoria Australia"},{"name":"Victorian Comprehensive Cancer Centre Alliance  Melbourne Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2819-4217","authenticated-orcid":false,"given":"Karla","family":"Gough","sequence":"additional","affiliation":[{"name":"Department of Nursing University of Melbourne  Melbourne Victoria Australia"},{"name":"Centre for Health Services Research Peter MacCallum Cancer Centre  Melbourne Victoria Australia"},{"name":"Sir Peter MacCallum Department of Oncology University of Melbourne  Melbourne Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,3,25]]},"reference":[{"key":"e_1_2_10_2_1","unstructured":"Leukaemia Foundation.Blood Cancer Facts and Figures 2024 (2024) https:\/\/www.leukaemia.org.au\/blood\u2010cancer\/understanding\u2010your\u2010blood\/blood\u2010cancer\u2010facts\u2010and\u2010figures\/#:~:text=It%20is%20expected%20that%2019%2C403 in%20the%20past%2010%20years."},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1473-3099(16)30213-4"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0049-3848(20)30391-1"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0227772"},{"key":"e_1_2_10_6_1","first-page":"50","article-title":"Providers Must Lead the Way in Making Value the Overarching Goal","volume":"53","author":"Porter M. 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