# Missing data, missed risks: complications and documentation gaps of central venous access devices in pediatric oncology

## TL;DR

This study highlights documentation gaps in tracking central venous access devices in pediatric oncology, which can lead to complications like infections.

## Contribution

The study introduces a mixed-methods approach combining Delphi consensus and cohort analysis to identify critical surveillance parameters for CVADs.

## Key findings

- 30 core surveillance parameters for CVADs were identified, with 23 found in routine records.
- 23.2% of CVADs experienced complications, primarily infections requiring premature removal.
- Standardized electronic documentation could improve surveillance and patient safety.

## Abstract

Central venous access devices (CVADs) are essential in pediatric oncology but frequently associated with infections, thromboses, and dysfunction. Although structured surveillance may reduce complications, implementation is limited by fragmented documentation across clinical systems.

We conducted a mixed-methods study combining a two-stage interdisciplinary electronic Delphi process with retrospective cohort analysis. Pediatric oncology patients diagnosed between 2020 and 2021 who received a CVAD at our university hospital were included. Data were manually extracted from three hospital information systems. Only the first CVAD per patient was analyzed (n = 112).

Of 219 diagnosed patients, 112 met inclusion criteria, accounting for 126 CVADs. The eDelphi panel identified 30 core surveillance parameters, 23 retrievable from routine records. Complications occurred in 23.2%, most commonly infections leading to premature removal.

Standardized electronic CVAD documentation could enhance surveillance, improve patient safety, and reduce manual data collection efforts.

The online version contains supplementary material available at 10.1186/s12887-026-06612-0.