{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,8]],"date-time":"2026-09-08T16:27:58Z","timestamp":1788884878215,"version":"build-2803163510"},"reference-count":44,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2024,5,27]],"date-time":"2024-05-27T00:00:00Z","timestamp":1716768000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["shmpublications.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Journal of Hospital Medicine"],"published-print":{"date-parts":[[2024,10]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Central venous access devices (CVADs) allow intravenous therapy, haemodynamic monitoring and blood sampling but many fail before therapy completion.<\/jats:p><\/jats:sec><jats:sec><jats:title>Objective<\/jats:title><jats:p>To quantify CVAD failure and complications; and identify risk factors.<\/jats:p><\/jats:sec><jats:sec><jats:title>Designs, Settings, and Participants<\/jats:title><jats:p>Secondary analysis of multicentre randomised controlled trial including patients aged \u226516 years with a non\u2010tunnelled CVAD (NTCVAD), peripherally\u2010inserted central catheter (PICC) or tunnelled CVAD (TCVAD). Primary outcome was incidence of all\u2010cause CVAD failure (central line\u2010associated bloodstream infection [CLABSI], occlusion, accidental dislodgement, catheter fracture, thrombosis, pain). Secondary outcomes were CLABSI, occlusion and dislodgement. Cox regression was used to report time\u2010to\u2010event associations.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>In 1892 CVADs, all\u2010cause failure occurred in 10.2% of devices: 49 NTCVADs (6.1%); 100 PICCs (13.2%); 44 TCVADs (13.4%). Failure rates for CLABSI, occlusion and dislodgement were 5.3%, 1.8%, and 1.7%, respectively. Independent CLABSI predictors were blood product administration through PICCs (hazard ratio (HR) 2.62, 95% confidence interval (CI) 1.24\u20135.55); and in TCVADs, one or two lumens, compared with three to four (HR 3.36, 95%CI 1.68\u20136.71), intravenous chemotherapy (HR 2.96, 95%CI 1.31\u20136.68), and diabetes (HR 3.25, 95%CI 1.40\u20137.57). Independent factors protective for CLABSI include antimicrobial NTCVADs (HR 0.23, 95%CI 0.08\u20130.63) and lipids in TCVADs (HR 0.32, 95%CI 0.14\u20130.72). NTCVADs inserted at another hospital (HR 7.06, 95%CI 1.48\u201333.7) and baseline infection in patients with PICCs (HR 2.72, 95%CI 1.08\u20136.83) were predictors for dislodgement. No independent occlusion predictors were found. Modifiable risk factors were identified for CVAD failure, which occurred for 1\u2010in\u201010 catheters. Strict infection prevention measures and improved CVAD securement could reduce CLABSI and dislodgement risk.<\/jats:p><\/jats:sec>","DOI":"10.1002\/jhm.13414","type":"journal-article","created":{"date-parts":[[2024,5,27]],"date-time":"2024-05-27T04:34:22Z","timestamp":1716784462000},"page":"905-917","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":20,"title":["Incidence and risk factors for central venous access device failure in hospitalized adults: A multivariable analysis of 1892 catheters"],"prefix":"10.1002","volume":"19","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4250-4077","authenticated-orcid":false,"given":"Amanda","family":"Corley","sequence":"first","affiliation":[{"name":"School of Nursing and Midwifery Griffith University Nathan Queensland Australia"},{"name":"Nursing and Midwifery Research Centre Royal Brisbane and Women's Hospital Herston Queensland Australia"},{"name":"Menzies Health Institute Queensland Griffith University Nathan Queensland Australia"},{"name":"Alliance for Vascular Access Teaching and Research Group Schools of Nursing and Midwifery &amp; Pharmacy and Medical Sciences Griffith University Nathan Queensland Australia"},{"name":"UQ Centre for Clinical Research, School of Nursing, Midwifery and Social Work The University of Queensland Brisbane Queensland Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ruth H.","family":"Royle","sequence":"additional","affiliation":[{"name":"Menzies Health Institute Queensland Griffith University Nathan Queensland Australia"},{"name":"School of Medicine and Dentistry Griffith University Nathan Queensland Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5779-1304","authenticated-orcid":false,"given":"Nicole","family":"Marsh","sequence":"additional","affiliation":[{"name":"School of Nursing and Midwifery Griffith University Nathan Queensland Australia"},{"name":"Nursing and Midwifery Research Centre Royal Brisbane and Women's Hospital Herston Queensland Australia"},{"name":"Menzies Health Institute Queensland Griffith University Nathan Queensland Australia"},{"name":"Alliance for Vascular Access Teaching and Research Group Schools of Nursing and Midwifery &amp; Pharmacy and Medical Sciences Griffith University Nathan Queensland Australia"},{"name":"UQ Centre for Clinical Research, School of Nursing, Midwifery and Social Work The University of Queensland Brisbane Queensland Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6272-8484","authenticated-orcid":false,"given":"Emily N.","family":"Larsen","sequence":"additional","affiliation":[{"name":"School of Nursing and Midwifery Griffith University Nathan Queensland Australia"},{"name":"Nursing and Midwifery Research Centre Royal Brisbane and Women's Hospital Herston Queensland Australia"},{"name":"Menzies Health Institute Queensland Griffith University Nathan Queensland Australia"},{"name":"Alliance for Vascular Access Teaching and Research Group Schools of Nursing and Midwifery &amp; Pharmacy and Medical Sciences Griffith University Nathan Queensland Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"E. 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