高龄病人PICC导管相关性上肢深静脉血栓发生风险列线图模型的构建OACSTPCD

Objective:To construct a Nomogram predicting model for assessing the risk factors of peripherally inserted central catheter(PICC)related upper extremity deep venous thrombosis(DVT)in elderly patients,and to evaluate the discrimination and consistency of the model.Methods:The clinical data of 226 elderly patients with PICC in researched hospital from January 2014 to December 2019 were retrospectively analyzed by self-design questionnaire.The incidence of catheter-related upper extremity DVT was calculated.Research subjects were divided into DVT group and non DVT group.The risk factors related to upper extremity DVT occurrence were screened by Logistic regression model,and the risk factors were included in R software to construct the risk factors of upper extremity DVT.The discrimination and consistency of the prediction model were evaluated by ROC curve and goodness-of-fit test.Results:The incidence of upper extremity DVT in elderly patients with PICC was 20.35%(46/226).The results of Logistic regression model showed that the age,malignant tumor,D-D level before catheterization and operation history during catheterization were independent risk factors for upper extremity DVT in elderly patients with PICC(P<0.05);The area under the ROC curve of the Nomogram model model is 0.777,the slope of calibration curve was close to 1,and the Hosmer-Lemeshow goodness-of-fit test showed χ2=9.637,P=0.291.Conclusion:The Nomogram model based on the risk factors of PICC related upper extremity DVT in elderly patients has good discrimination and consistency,which has certain clinical guiding value for the prevention of upper extremity DVT in elderly patients with PICC.