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. 2017 Jul 24;7(1):6344.
doi: 10.1038/s41598-017-06609-x.

Nomogram predicted risk of peripherally inserted central catheter related thrombosis

Nan Hao  1 , Xin Xie  1 , Zhangjian Zhou  1 , Jieqiong Li  2 , Li Kang  3 , Huili Wu  4 , Pingli Guo  5 , Chengxue Dang  6 , Hao Zhang  7
Affiliations

Nomogram predicted risk of peripherally inserted central catheter related thrombosis

Nan Hao et al. Sci Rep. .

Abstract

The use of peripherally inserted central catheters (PICCs) is increasing rapidly worldwide. A number of patient-related, clinical-related and device-related characteristics might be risk factors for PICC-related thrombosis. We retrospectively reviewed a database of 320 consecutive patients who underwent PICC insertion between December 2014 and December 2015 at the First Affiliated Hospital of Xi'an Jiaotong University to explore the potential associations between risk factors and PICC-associated thrombosis. A novel nomogram for predicting risk was developed based on the data. The nomogram prediction model included ten risk factors that were derived from different relevant estimates. The nomogram prediction model showed good discriminatory power (Harrell's C-index, 0.709) and a high degree of similarity to actual thrombosis occurring after calibration. Furthermore, principal component analysis was performed to identify the factors that most influence PICC-related thrombosis. Our novel nomogram thrombosis risk prediction model was accurate in predicting PICC-related thrombosis. Karnofsky performance scores, D-dimer and blood platelet levels and previous chemotherapy were principal components. Our findings might help clinicians predict thrombosis risk in individual patients, select proper therapeutic strategies and optimize the timing of anticoagulation therapy.

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Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Figure 1
Figure 1
Cumulative thrombosis free rate of the duration of PICC insertion.
Figure 2
Figure 2
Cumulative thrombosis free rate of the duration of PICC insertion for the dichotomous variables. (A) Thrombosis history or not. (B) Center care or not. (C) Previous chemotherapy or not. (D) Have other complications or not.
Figure 3
Figure 3
(A) The cluster of potential ten risk factors that associated with thrombosis. The plot shown the factorial maps with representation of observation scores. (B) The scree plot indicated principal components.
Figure 4
Figure 4
Nomogram predicted PICC associated thrombosis risk using the four chief characteristics.
Figure 5
Figure 5
Calibration of the nomogram predicted system. Nomogram predicted probability of thrombosis was plotted on the x-axis, actual PICC associated thrombosis was plotted on the y-axis and 95% CIs measured by logistic regression analysis. All predictions lie within the 10% margin of error (within the blue dots line).
See this image and copyright information in PMC

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