Construction and validation of a nomogram prediction model for the risk of accidental syndrome after central venous catheter removal in ICU patients
Objective To explore the influencing factors of unexpected syndrome after central venous catheter(CVC)re-moval in intensive care unit(ICU)patients,so as to provide preventive measures to reduce the occurrence of events.Method A total of 3,016 patients who underwent CVC catheterization in ICU of our hospital from January 2018 to December 2022 were retrospectively collected.They were divided into an incidence group of 28 cases and a non incidence group of 2,988 ca-ses based on the occurrence of accidental CVC removal syndrome.Basic information,past history,and catheterization status of patients between two groups were compared,and logistic regression analysis was used to identify risk factors and explore the nursing prevention measures.Results The incidence of unexpected syndrome after CVC removal in ICU was 0.93％.Age≥65 years old,catheterization time≥7 d,history of coronary heart disease,catheter-related bloodstream infection,and air embolism were risk factors for CVC catheterization patients to develop unexpected syndrome after CVC removal.The nomogram model was constructed by using the above 5 predictive factors,which was internally validated by Bootstrap re-peated sampling 1,000 times,and a calibration curve was drawn toshow a good fit between the calibration curve and the ide-al curve.The results of the Hosmer-Lemreshow goodness of fit test showed that x2=7.240,P=0.412,indicating a good fit of the model.AUC=0.742,the sensitivity was 69.08％,the specificity was 79.32％,and the prediction results were good,and the DCA curve and clinical decision curve both indicated good clinical practicality.Conclusion Age≥65years old,catheterization time≥7 d,history of coronary heart disease,catheter-related bloodstream infection,and air embolism are in-dependent risk factors for CVC removal syndrome in ICU patients.The nomogram model based on this is of great signifi-cance for early intervention by nursing staff to reduce the risk of central venous catheter removal syndrome.
intensive care unitcentral venous catheteraccidental removal syndromerisk factorsnomogram
万方数据
维普
