Analysis Of Risk Factors And Risk Model Of Peripherally Inserted Central Catheter Thrombosis

ObjectiveTo investigate the main risk factors of peripherally inserted central catheter(PICC) related upper extremity deep venous thrombosis and establish its risk predictive model. So that the model can provide some guideline for venous thrombosis assessment, prevention and clinical treatment.Methods242 cases with picc were prospectively analyzed in a hospital of Tianjin between March 2014 and January 2016. The data collection case report form contained the general information of patients, disease-related information, catheter-related information and laboratory indicators. they were investigated for venous thrombosis by Doppler sonography every seven days within one month after catheter insertion,and were divided into thrombosis group patients complicated with PICC related upper extremity deep venous thrombosis after PICC and no-thrombosis group patients without venous thrombosis.After completion of the information collected, SPSS18.0 statistical software was used for data analysis and processing. Statistically significant differences were filtered from the upper data which were used to analyze the independent risk factors of PICC related upper extremity deep venous thrombosis followed by multivariate logistic regression analysis. Then the risk prediction model of fatality was established and evaluated by the receiver operating characteristic cure(ROC) and the cutoff was determined.Results(1) A total of 242 patients were studied in our research, dividing into thrombosis group(n=52) and no-thrombosis group(n =144). The incidence of PICC related upper extremity thrombosis was 18.6%, Nine variables, including diameter of blood vessel,catheter tip position, cancer, history of diabetes, chemotherapy history, history of thrombosis, PICC catheter history, activity and D-dimer. The multivariate analysis showed that catheter tip position( OR=8.671, P=0.005), history of diabetes(OR=5.582, P=0.040), chemotherapy history(OR=5.128, P=0.042)and D-dimer( OR=1.437, P=0.046) were independent risk factors for PICC related upper extremity deep venous thrombosis.(2)logistic regression predictive model was as following: Y=6 × catheter tipposition +5×history of diabetes+5×chemotherapy history +1×D-dimer.(3) According to the ROC, the area under the receiver operating characteristic curve for the model was 0.816, The cutoff point was 6.045. The sensitivity of the model was 0.810, specificity was 0.735.Conclusionscatheter tip position, history of diabetes, chemotherapy history and D-dimer were the independent factors for PICC-related upper extremity deep venous thrombosis. The predictive model was simple and reliable with high sensitivity and specificity, which has important clinical significance in predicting the PICC related upper extremity deep venous thrombosis.