The Hidden Price of Paediatric CVAD Complications: What Costs Are We Really Paying?

Study Overview

Central venous access devices (CVADs) are essential in paediatric care, but complications—both infectious and non-infectious—can trigger major downstream impacts: longer stays, extra treatment, device replacement, and more procedures. This systematic review pulled together published evidence on the average cost of CVAD-associated complications in children and explored why cost estimates vary so widely.

The authors searched studies published January 2012 to January 2025 and included 22 studies that calculated paediatric CVAD complication costs in hospital-based care.

Key Findings

- Infectious complications are extremely expensive
Reported costs per infectious complication ranged widely—from ~$3,684 to ~$378,289 (2024 USD). When pooled across studies with enough data, the average cost per infectious complication was estimated at ~$77,375 (2024 USD).

- Non-infectious complications ranged from “small” to “huge” depending on type
Only a few studies reported non-infectious complication costs, but estimates varied massively—from ~$7 (some insertion-related issues) up to ~$45,598 (e.g., central venous stenosis).

- Where you are and who you treat changes the cost
Costs differed by country, specialty area, and setting. Infectious complications in high-cost health systems and complex populations (e.g., haematology/oncology) tended to have higher estimates.

- Cost reporting is inconsistent (and that’s a big problem)
Many studies didn’t clearly explain what was included in their costing, and only a small number explicitly stated the costing method used. This lack of transparency makes it hard to compare studies or confidently use published numbers for planning.

Implications

This review makes one message loud and clear: CVAD complications—especially infections—are not just clinical events; they’re major cost events. But the bigger issue is that the field still lacks consistent, transparent costing methods, meaning hospitals often can’t confidently benchmark or build strong business cases using published estimates alone.

For real-world decision-making, the most useful next steps are:

• Do local costing (using your own hospital data) to estimate the true financial impact in your setting.
• Standardise what you count (e.g., length of stay, diagnostics, antimicrobials, procedures, device replacement, staff time) so estimates are comparable and defensible.
• Use cost data to justify prevention (bundles, dressings, lock solutions, training, escalation pathways)—because even small reductions in infection rates can translate into substantial savings.

Read More:https://www.journalofhospitalinfection.com/article/S0195-6701(25)00365-2/fulltext 

Authors: E.R. Comber; A.J. Ullman; S. Hall; M. Takashima; L. Nguyen; S. Keogh; J. Byrnes