Risk Factors Associated With Failure of Ultrasound‐Cannulated Vascular Access Devices Due to Complications in Adult Inpatients: A Retrospective Observational Study

Background Ultrasound‐guided cannulation of vascular access devices (VADs) is one of the fastest‐growing invasive procedures due to its benefits, but complications continue to arise. Objectives To determine the risk factors for failure of ultrasound‐cannulated VAD by a vascular access team (VAT) due to complications in adult inpatients and to develop a model to predict the risk of complications. Methods An observational and retrospective study was carried out. All patients who were treated by a VAT in a secondary care hospital were included. A dataset including demographic and clinical variables, pertaining to VAD and its associated complications, was systematically collected. Bivariate and multivariate logistic regression models were used. Furthermore, a sequential classification tree was determined. Results A total of 1454 patients were included, 55.9% were male, with a mean age of 67.4 years. The types of catheters that were cannulated included 42.7% peripherally inserted central catheter, 56.7% midlines, and 0.6% short peripheral intravenous cannulation. A total of 15.4% of the patients presented a failure of VAD. The multivariate model determined the following set of independent predictive factors associated with a higher risk of complications: age < 66 years; left arm puncture; cephalic vein cannulation; and less than seven days with catheter. Additionally, two high‐risk factors were identified: cannulation in the cephalic vein in either arm at any age or cannulation in noncephalic veins in the left arm in patients younger than 66 years. Conclusion Cephalic vein cannulation or left arm puncture in patients younger than 66 years is associated with a higher risk of complications after ultrasound‐guided catheter cannulation. Trial Registration: Clinical trial.gov.identifier; NCT06770361.