TAO Yong , MAO Jingyu , XUE Mei , WANG Liying , LI Yanxia , WEN Ping , GUAN Zhenfang , XU Pei , ZHOU Linshan
  • Department of Nursing, Fudan University Shanghai Cancer Center, Shanghai 200032, P. R. China;
MAO Jingyu, Email: baobeiyu1005@sina.com
Peripherally inserted central catheter (PICC); Unplanned extubation; Risk factor; Risk nomogram model
10.7507/1672-2531.202406180
Export PDF Favorites Scan Get Citation

Abstract Full text Figures/Tables References Cited by

Objective To retrospectively analyze the causes and risk factors of unplanned extubation (UE) in cancer patients during peripherally inserted central catheter (PICC) retention, so as to provide references for effectively predicting the occurrence of UE. Methods 27 998 cancer patients who underwent PICC insertion, maintenance and removal in the vascular access nursing center of our hospital from January 2016 to June 2023 were retrospectively analyzed. General information, catheterization information, and maintenance information were collected. The Chi-squared test was used for univariate analysis, multivariate analysis was used by binary unconditional logistic regression. They were randomly divided into modeling group and internal validation group according to the ratio of 7∶3. The related nomogram prediction model and internal validation were established. Results The incidence of UE during PICC retention in tumor patients was 2.80% (784/27 998 cases). Univariate analysis showed that age, gender, diagnosis, catheter retention time, catheter slipping, catheter related infection, catheter related thrombosis, secondary catheter misplacement, dermatitis, and catheter blockage had an impact on UE (P<0.05). Age, diagnosis, catheter retention time, catheter slipping, catheter related infection, catheter related thrombosis, secondary catheter misplacement, and catheter blockage are independent risk factors for UE (P<0.05). Based on the above 8 independent risk factors, a nomogram model was established to predict the risk of UE during PICC retention in tumor patients. The ROC area under the predicted nomogram was 0.90 (95%CI 0.89 to 0.92) in the modeling group, and the calibration curve showed good predictive consistency. Internal validation showed that the area under the ROC curve of the prediction model was 0.91 (95%CI 0.89 to 0.94), and the trend of the prediction curve was close to the standard curve. Conclusion Patients aged ≥60 years, non chest tumor patients, catheter retention time (≤6 months), catheter slipping, catheter related infections, catheter related thrombosis, secondary catheter misplacement, and catheter blockage increase the risk of UE. The nomogram model established in this study has good predictive ability and discrimination, which is beneficial for clinical screening of patients with different degrees of risk, in order to timely implement targeted prevention and effective treatment measures, and ultimately reduce the occurrence of UE.

Citation： TAO Yong, MAO Jingyu, XUE Mei, WANG Liying, LI Yanxia, WEN Ping, GUAN Zhenfang, XU Pei, ZHOU Linshan. Establishment of risk factors and risk nomogram model for unplanned extubation during peripherally inserted central catheter retention in cancer patients. Chinese Journal of Evidence-Based Medicine, 2025, 25(1): 57-63. doi: 10.7507/1672-2531.202406180 Copy

Copyright ? the editorial department of Chinese Journal of Evidence-Based Medicine of West China Medical Publisher. All rights reserved

  • Previous Article

    Association between gut microbiota and urinary tract infection: a two-sample Mendelian randomization study

  • Next Article

    Disease burden of different treatment measures for chronic obstructive pulmonary disease: a systematic review and network meta-analysis