关键词: 经外周静脉置入中心静脉导管；导管相关血流感染；危险因素；预测；列线图

Abstract: Objective: To analyze the risk factors of Catheter-Related Bloodstream Infection (CRBSI) in cancer patients during PICC retention, and to establish a prediction model. Methods: Totally 11901 cancer patients who underwent PICC insertion, maintenance and removal in the vascular access nursing clinic of a tertiary grade A hospital in Shanghai from January 2017 to December 2019 were retrospectively analyzed. Logistic regression were used to analyze the independent risk factors of CRBSI. Based on the risk factors, a nomogram prediction model was established, and bootstrap method was used for internal validation. Results: The incidence of CRBSI during PICC retention was 0.39%. Multivariate analysis results showed that dermatitis, catheter-related thrombosis, local infection and exudation were independent risk factors for CRBSI. The trend of the prediction curve was close to the standard curve, and the consistency index was 0.825 (95%CI: 0.78-0.91). The ROC curve had an area under the curve of 0.950 (95%CI: 0.917-0.996), and the trend of the prediction curve of the validation group is close to the standard curve. Conclusion: Dermatitis, catheter-related thrombosis, local infection and exudation during PICC retention were independent risk factors for CRBSI. The nomogram model established in this study has good predictive ability and differentiation, which is conducive to clinical screening of high-risk patients.

Key words: Peripherally Inserted Central Catheter (PICC); Catheter-Related Bloodstream Infection (CRBSI); risk factors; prediction; nomogram