全科护理2025，Vol.23Issue(4)：714-719,6.DOI:10.12104/j.issn.1674-4748.2025.04.026
危重症病人双腔中心静脉导管功能障碍风险预测模型的构建与验证
Construction and validation of a risk prediction model for double-lumen central venous catheter dysfunction in critically ill patients
摘要
Abstract
Objective:To construct and validate a risk prediction model for dysfunction of double-lumen central venous catheters in critically ill patients.Methods:A convenience sampling method was used to select 635 patients with double-lumen central venous catheters in the intensive care unit of a tertiary hospital from December 2023 to March 2024.Clinical data were collected,and catheter function was routinely assessed daily.Univariate analysis and Logistic regression analysis were used to identify influencing factors for catheter dysfunction in critically ill patients.Based on these factors,a risk prediction model for catheter dysfunction was constructed.The Hosmer-Lemeshow test and the area under the receiver operating characteristic(ROC)curve(AUC)were used to evaluate the model's fit and predictive performance.Results:The incidence of double-lumen central venous catheter dysfunction in critically ill patients was 38.97%.Logistic regression analysis revealed that COPD[OR=3.336,95%CI(1.359,8.337),P<0.05],D-dimer concentration[OR=1.125,95%CI(1.077,1.175),P<0.001],and improper flushing and sealing of the catheter[OR=1.784,95%CI(1.091,2.918),P<0.05]were independent risk factors for catheter dysfunction.The Hosmer-Lemeshow test showed χ2=14.097,P=0.079,and AUC was 0.735[95%CI(0.686,0.784),P<0.001],the optimal critical value was 0.375,the sensitivity was 0.569 and the specificity was 0.806.The results of validation showed that the sensitivity was 0.632,the specificity was 0.736,and the accuracy rate was 80.90%.Conclusion:The risk prediction model for double-lumen central venous catheter dysfunction in critically ill patients has a small number of items and good predictive performance,providing a reference for the rapid clinical screening of high-risk patients for catheter dysfunction.关键词
双腔中心静脉导管/功能障碍/风险模型/危险因素/危重症病人/护理Key words
double-lumen central venous catheter/dysfunction/risk prediction model/risk factors/critically ill patients/nursing引用本文复制引用
贾秀芬,刘玉平,高晶,陈翠,张娟,蒋丽,张艳丹,张娟娟,张杰..危重症病人双腔中心静脉导管功能障碍风险预测模型的构建与验证[J].全科护理,2025,23(4):714-719,6.基金项目
中华护理杂志社2023年静脉治疗护理专项科研项目,编号:ZHHLZZS-202322 （）
徐州市科技局2023年度医药卫生面上项目,编号:KC23282. （）
