Development of a risk prediction model for central venous catheter insertion-related thrombosis in critically ill pediatric patients

为危重症儿科患者建立中心静脉导管插入相关血栓形成风险预测模型

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Abstract

INTRODUCTION: Central venous catheter-related thrombosis (CVC-RT) is a serious complication associated with CVC insertion that significantly adversely affects the prognosis of critically ill children. This study aimed to identify risk factors for CVC-RT following CVC placement in critically ill children and to develop a corresponding risk prediction model. METHODS: A total of 188 critically ill children with CVCs were enrolled and categorized into thrombosis and non-thrombosis groups. Clinical data were collected to analyze risk factors for CVC-RT, and a nomogram prediction model was developed and validated for its predictive performance. RESULTS: Among the 188 children, 31 developed CVC-RT, yielding an incidence rate of 16.5%. Significant differences were observed between the two groups in terms of age, catheter type, parenteral nutrition status, D-dimer levels, and fibrinogen (FIB) levels. All of these factors, except catheter type, were identified as independent predictors of CVC-RT. The constructed nomogram prediction model demonstrated strong predictive performance and discriminative ability, with an area under the receiver operating characteristic curve of 0.952. DISCUSSION: In summary, this study identified age, parenteral nutrition, D-dimer, and FIB levels as independent influencing factors for CVC-RT in critically ill children. The nomogram model incorporating these factors exhibited favorable predictive value.

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