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The aims of the present study were to determine the incidence of tip misplacements and to identify independent variables associated with tip misplacement.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>All jugular and subclavian central venous catheter insertions in patients \u226516\u2009years with a post\u2010procedural chest radiography at four hospitals were included. Each case was reviewed for relevant catheter data and radiologic evaluations of chest radiographies. Tip misplacements were classified as \u2018any tip misplacement\u2019, \u2018minor tip misplacement\u2019 or \u2018major tip misplacement\u2019. Multivariable logistic regression analyses were used to investigate associations between predefined independent variables and tip misplacements.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 8556 central venous catheter insertions in 5587 patients were included. Real\u2010time ultrasound guidance was used in 91% of all insertions. Any tip misplacement occurred (95% confidence interval) in 3.7 (3.3\u20134.1)% of the catheterisations, and 2.1 (1.8\u20132.4)% were classified as major tip misplacements. The multivariable logistic regression analyses showed that female patient gender, subclavian vein insertions, number of skin punctures and limited operator experience were associated with a higher risk of major tip misplacement, whereas increasing age and height were associated with a lower risk.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>In this large prospective multicentre cohort study, performed in the ultrasound\u2010guided era, we demonstrated the incidence of tip misplacements to be 3.7 (3.3\u20134.1)%. Right internal jugular vein catheterisation had the lowest incidence of both minor and major tip misplacement.<\/jats:p><\/jats:sec>","DOI":"10.1111\/aas.14380","type":"journal-article","created":{"date-parts":[[2024,2,14]],"date-time":"2024-02-14T05:34:25Z","timestamp":1707888865000},"page":"520-529","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["Central venous catheter tip misplacement: A multicentre cohort study of 8556 thoracocervical central venous catheterisations"],"prefix":"10.1111","volume":"68","author":[{"ORCID":"https:\/\/orcid.org\/0009-0003-7112-9303","authenticated-orcid":false,"given":"Emilia","family":"\u00c4ngeby","sequence":"first","affiliation":[{"name":"Department of Clinical Sciences Lund University  Lund Sweden"},{"name":"Department of Intensive and Perioperative Care Sk\u00e5ne University Hospital  Lund Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria","family":"Adrian","sequence":"additional","affiliation":[{"name":"Department of Clinical Sciences Lund University  Lund Sweden"},{"name":"Department of Cardiothoracic Surgery, Anaesthesia and Intensive Care Sk\u00e5ne University Hospital  Lund Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gracijela","family":"Bozovic","sequence":"additional","affiliation":[{"name":"Department of Clinical Sciences Lund University  Lund Sweden"},{"name":"Department of Medical Imaging and Clinical Physiology Sk\u00e5ne University Hospital  Lund Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ola","family":"Borgquist","sequence":"additional","affiliation":[{"name":"Department of Clinical Sciences Lund University  Lund Sweden"},{"name":"Department of Cardiothoracic Surgery, Anaesthesia and Intensive Care Sk\u00e5ne University Hospital  Lund Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5404-2981","authenticated-orcid":false,"given":"Thomas","family":"Kander","sequence":"additional","affiliation":[{"name":"Department of Clinical Sciences Lund University  Lund Sweden"},{"name":"Department of Intensive and Perioperative Care Sk\u00e5ne University Hospital  Lund Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2024,2,13]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.1111\/anae.14679"},{"key":"e_1_2_11_3_1","doi-asserted-by":"publisher","DOI":"10.1111\/anae.13360"},{"key":"e_1_2_11_4_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00134-001-1154-9"},{"key":"e_1_2_11_5_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.286.6.700"},{"key":"e_1_2_11_6_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00134-007-0560-z"},{"key":"e_1_2_11_7_1","doi-asserted-by":"publisher","DOI":"10.1097\/00003246-200202000-00031"},{"key":"e_1_2_11_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jvir.2007.09.005"},{"key":"e_1_2_11_9_1","doi-asserted-by":"publisher","DOI":"10.2147\/RMHP.S10383"},{"key":"e_1_2_11_10_1","doi-asserted-by":"publisher","DOI":"10.1097\/RTI.0b013e31825d2db9"},{"key":"e_1_2_11_11_1","doi-asserted-by":"publisher","DOI":"10.1177\/08850666221076798"},{"key":"e_1_2_11_12_1","doi-asserted-by":"publisher","DOI":"10.1177\/0885066605280884"},{"key":"e_1_2_11_13_1","doi-asserted-by":"publisher","DOI":"10.1177\/0310057X0803600106"},{"key":"e_1_2_11_14_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00134-019-05651-9"},{"key":"e_1_2_11_15_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.bja.2022.08.036"},{"key":"e_1_2_11_16_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijsu.2014.07.013"},{"key":"e_1_2_11_17_1","doi-asserted-by":"publisher","DOI":"10.1093\/annonc\/mdm350"},{"key":"e_1_2_11_18_1","doi-asserted-by":"publisher","DOI":"10.1182\/asheducation-2014.1.306"},{"key":"e_1_2_11_19_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.RVI.0000071097.76348.72"},{"key":"e_1_2_11_20_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1055-3207(18)30433-2"},{"issue":"5","key":"e_1_2_11_21_1","first-page":"459","article-title":"Cardiac tamponade caused by central venous catheter perforation of the heart: a preventable complication","volume":"181","author":"Collier PE","year":"1995","journal-title":"J Am Coll Surg"},{"key":"e_1_2_11_22_1","unstructured":"Lloyd\u2010JonesG.Chest X\u2010ray \u2013 tubes. 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