Prediction of post-insertion infections related to totally implantable subcutaneous venous access ports in tumor patients using a nomogram

利用列线图预测肿瘤患者完全植入式皮下静脉通路装置植入后感染情况

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Abstract

Totally implantable subcutaneous venous access ports (TISVAPs) are essential for long-term central venous chemotherapy, delivering medication directly into the central veins of patients. While they play a critical role in reducing patient discomfort, TISVAPs pose a notable risk of post-insertion infections-particularly concerning for oncology patients with compromised immune systems due to aggressive treatment regimens. Our research addresses this issue by developing a predictive nomogram to estimate the risk of TISVAP-associated infections. The model is based on independent risk factors identified in our study: a history of diabetes, the type of chemotherapy, peripheral blood leukocyte count (WBC), and serum albumin levels. Using retrospective clinical data from 309 oncology patients who underwent TISVAP implantation at a tertiary A-grade comprehensive hospital, we divided the dataset into training (n = 246) and validation (n = 63) subsets. Through logistic and Lasso regression analyses, we identified the independent risk factors associated with infections. The resulting interactive nomogram demonstrated strong accuracy and reliability, with C-indexes of 0.82 and 0.835 for the training and validation sets, respectively. This tool equips healthcare providers to proactively identify high-risk patients and tailor preventive strategies accordingly. Ultimately, our research aims to enhance patient outcomes and improve the quality of life for those undergoing long-term venous chemotherapy.

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