Analysis of Influencing Factors of Pediatric Central Venous Access Device-Associated Thrombus and Construction of Nomogram Prediction Model
JIN Xiao-ye, ZHANG Yan-yu, LI Ning
2025, 43(4):
52-56.
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Objective To analyze the factors affecting pediatric central venous access device-associated thrombosis(CADVT) and construct a nomogram prediction model. Methods The clinical data of 105 children who received central venipuncture catheters in the department of Pediatrics of the hospital from February 2021 to February 2024 were retrospectively analyzed, and they were divided into thrombus group and non-thrombus group according to whether CADVT was complicated during treatment. Clinical data of enrolled patients were collected and recorded, and the risk factors affecting pediatric CADVT were screened by Logistic multivariate regression analysis, a pediatric CADVT risk nomogram model was constructed based on the above risk factors, goodness of fit test and receiver operating characteristic (ROC) curve were used to evaluate the predictive efficacy of the nomogram model. Results According to clinical evaluation, CADVT occurred in 30 of 105 children who received central venipuncture during treatment, with an incidence of 28.57%. There were significant differences in critical case score (PCIS) score, catheterization duration ≥7 d, vasoconstrictor use ≥2 types, sedation days ≥7 d, D-dimer (D-D) and fibrinogen (FIB) levels between thrombus group and non-thrombus group (P<0.05), there were no significant differences in sex ratio, age, body mass index (BMI), placement, number of catheters and WBC (P>0.05). Logistic multivariate regression analysis assigned the following values: PCIS score (OR=3.408, 95%CI: 1.498~7.752), catheter placement duration ≥7 days (OR=3.971, 95%CI: 1.746~9.033), vasoconstrictor use ≥2 (OR=2.507, 95%CI: 1.102~5.702), sedation days ≥7 days (OR=2.323, 95%CI: 1.021~5.285), D-D (OR=3.459, 95%CI: 1.521~7.869), FIB (OR=3.304, 95%CI: 1.452~7.515) were independent risk factors for pediatric CADVT. The measured values of the pediatric CADVT risk nomogram model constructed according to the above risk factors were basically consistent with the predicted values, and the C-index was 0.895 (95%CI: 0.796~0.937). Conclusion PCIS score, catheterization duration, vasoconstrictor use, sedation days, D-D and FIB were the risk factors affecting the occurrence of pediatric CADVT, and the pediatric CADVT nomogram model constructed based on this was effective in predicting the occurrence of pediatric CADVT.