Abstract
BACKGROUND: Central venous catheter (CVC)-related thrombosis (CRT) has become a common iatrogenic complication in burn patients. Early and precise prediction is the foundations of effective prevention of CRT. However, there is not specific tool to predict CRT in burn populations. This study aimed to investigate the risk factors of CRT and develop a prediction model for CRT in burn populations. METHODS: This retrospective observational study was conducted at a large burn center in Southwest China from January 2018 to December 2022. All adult patients with burn injuries undergoing central venous catheterization were included in the cohort. The clinical data, thrombosis profile, and catheter management were collected and analyzed. RESULTS: A total of 271 burn patients (mean burn area: 53.29 ± 23.65%) with 797 CVCs were finally included. The incidence of CRT was 13.28%, with a mean time from burn injuries to CRT onset of 25.96 ± 19.00 days. Half of the thrombotic events occurred between 15 and 30 days following burn trauma. Notably, 91.07% and 87.5% of CRT cases had diameters less than 5 mm and lengths shorter than 7 mm, respectively. Compared with the non-CRT cohort, the CRT cohort exhibited significantly larger burn area, more insertion times, higher proportion of blood purification procedures, and longer in-bed durations. Logistic regression and LASSO regression analyses identified burn index and continuous blood purification as independent risk factors for CRT. Consequently, a predictive nomogram model for CRT was successfully developed, achieving an AUROC of 0.75 (95% CI: 0.675-0.834) and a mean absolute error of the calibration curve of 0.029. CONCLUSION: The incidence of CRT was relatively high in burn populations. The established nomogram could provide a straightforward, quantitative and effective strategy for identifying patients at high-risk for CRT. Clinicians can utilize this assessment tool periodically to facilitate the early identification of individuals at high risk for CRT.