Comparison Of Predictive Power For PICC-related Venous Thromboembolism Among Cancer Patients Using Two Risk Assessment Scales

Objective:To compare predictive power for PICC-related venous thromboembolism in cancer patients using Autar scale and Caprini risk assessment scale.Methods: This was a retrospective study of 125 cancer patients from2012 to 2017.general information,catheter thrombosis cases were collected to establish the database.The Incidence PICC line related Deep Venous Thrombosis(DVT)which is defined as upper extremity DVT at the site of PICC line insertion was documented after checking reports of ultrasound Doppler of all symptomatic patients to confirm the presence of thrombo-embolism.Application spss22.0 statistical software package,statistical methods include:univariate analysis,Fisher's exact test,Wilcoxon-Mann-Whitney test,logistics regression analysis,the statistical result are by p'values of <0.05 were considered as statistically significant.(2)We Retrospectively analyzed 150 cases of cancer patients with general information and PICC catheter information.the patients weregraded and recorded according to the Caprini risk assessment scale.Multivariate logistic regression analysis was performed to establish the association between Caprini risk and presence of PICC-related.(3)The patients were graded and recorded according to the Autar scale and Caprini risk assessment scale.And we analyzed the best diagnostic boundary of the two scales.Result:(1)There were 35 cases of lung cancer,20 cases of colorectal cancer,10 cases of breast cancer,20 cases of pancreatic cancer,25 cases of non-hodgkin's lymphoma,5 cases of gastric cancer,5 cases of gallbladder cancer and 5 cases of leukemia.IThe univariate analysis show that the level of D-dimer and C-reactive protein were significantly different.n the group of thrombosis,the complications,previous VTE,lower limb edema,PICC tube tip in the vein were significantly higher.there four factors were independent risk factors for cancer patients with PICC related thrombosis.(2)The Autar scale score of the patients was(10.440 +2.501)and the Caprini risk score was(7.720 +1.768)respectively.The Autar scale score of the patients in the control group was(10.440 +2.501)and the Caprini risk score was(6.220 +1.097).The scores of patients in the case group were higher than those in the control group,and 72% of patients in the Caprini risk assessment model group had PICC-related venous thrombosis scores greater than or equal to 7.The proportion of patients with Autar scale score(> 11)was 28%.The difference was statisticallysignificant in the high control group(P < 0.05).Logistic regression analysis using risk factors in Caprini risk assessment model as independent variables showed that the major risk factors for PICC-related venous thrombosis in cancer patients were serious infection(for example,pneumonia),other risk factors,history of blood clots,either deep vein thrombosis(DVT)or pulmonary embolism(PE).Logistic regression analysis showed that age(>70 years old)and thrombosis history were the main risk factors for PICC-related venous thrombosis in cancer patients.(3)When the boundary value of Caprini risk assessment scale was7,and those of Autar scale was 10,its sensitivity and specificity were the best balance.The area under the ROC curve of Autar scale was 0.6342.The area under the ROC curve of Caprini risk assessment scale was 0.7626.Conclusion:multivariate logistics regression analysis shows that in cancer patients with PICC-related venous thrombosis were the complications,previous VTE,lower limb edema and neoplasm metastasis.(2)The Caprini risk assessment scale can effectively predict the risk of PICC related venous thrombosis in cancer patients.(3)The predictive power of Caprini risk assessment scale was higher than that of Autar scale which enabled Caprini risk assessment scale to better predict PICC-related venous thromboembolism for cancer patients.