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
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Construction of a Nomogram model for risk of PICC related upper extremity DVT in elderly patients
WANG Wei， HAO Qiyan
Yancheng Third People's Hospital， Jiangsu 224000 China
Corresponding Author HAO Qiyan， E⁃mail： 81860089@qq.com
Abstract 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.
Keywords peripherally inserted central venous catheter，PICC； upper extremity deep vein thrombosis； risk factors； Nomogram model； investigation study
摘要 目的：通过筛选高龄病人经外周静脉穿刺中心静脉置管（PICC）相关性上肢深静脉血栓（DVT）发生的危险因素，建立列线图预测模型，并评估模型的区分度与一致性。（剩余9590字）