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Background <p>Peripherally inserted central catheter (PICC)-related thrombosis (CRT) is a critical complication in cancer patients. However, the impact of vascular morphological parameters on the risk of this complication remains poorly understood. This study aimed to identify independent risk factors associated with vascular morphology and develop a nomogram for predicting CRT.</p> Methods <p>Cancer patients who underwent placement of a PICC at a tertiary hospital between 2021 and 2023 were retrospectively identified. Vascular parameters (vessel depth, vessel diameter, arm circumference) and procedural factors (cannulation/attempts, catheter tip position) were assessed by ultrasonography. Independent risk factors for CRT were identified by multivariate logistic regression and Cox proportional hazards models. A nomogram was constructed using the rms package in R. Discrimination was evaluated via the area under the curve and calibration by the Hosmer–Lemeshow goodness-of-fit test.</p> Results <p>A PICC was placed in 2,183 cancer patients during the study period. CRT occurred in 102 (4.7%) of these patients. Independent risk factors identified were a vascular depth &gt; 0.81&#xa0;cm from the skin surface (odds ratio [OR] 1.362, 95% confidence interval [CI] 1.022–2.294), arm circumference ≥ 27.35&#xa0;cm (OR 1.019, 95% CI 1.022–1.163), repeated cannulations (OR 3.218, 95% CI 1.597–6.482), and multiple catheter advancements (OR 3.110, 95% CI 1.409–6.862). The nomogram incorporating these parameters demonstrated good discriminative ability (area under the curve 0.739, 95% CI 0.684–0.794) and calibration (<i>P</i> = 0.126, Hosmer–Lemeshow test).</p> Conclusions <p>Several parameters related to vascular morphology and procedural factors have a significant impact on the risk of CRT. The nomogram proposed here is a practical tool that can be used for individualized assessment of CRT, enabling optimized catheter management strategies.</p>

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Development and validation of a nomogram incorporating vascular morphological parameters for prediction of peripherally inserted central catheter-related thromboembolism in cancer patients

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年8月4日

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  • Guodong Wang,
  • Yanfen Shen,
  • Xinpeng Wang,
  • Jie Chen,
  • Jing Dong,
  • Xiaozheng Wang,
  • Yuanyuan Zheng,
  • Xiaofang Meng,
  • Feng Liu,
  • Jun Dong

摘要

Background

Peripherally inserted central catheter (PICC)-related thrombosis (CRT) is a critical complication in cancer patients. However, the impact of vascular morphological parameters on the risk of this complication remains poorly understood. This study aimed to identify independent risk factors associated with vascular morphology and develop a nomogram for predicting CRT.

Methods

Cancer patients who underwent placement of a PICC at a tertiary hospital between 2021 and 2023 were retrospectively identified. Vascular parameters (vessel depth, vessel diameter, arm circumference) and procedural factors (cannulation/attempts, catheter tip position) were assessed by ultrasonography. Independent risk factors for CRT were identified by multivariate logistic regression and Cox proportional hazards models. A nomogram was constructed using the rms package in R. Discrimination was evaluated via the area under the curve and calibration by the Hosmer–Lemeshow goodness-of-fit test.

Results

A PICC was placed in 2,183 cancer patients during the study period. CRT occurred in 102 (4.7%) of these patients. Independent risk factors identified were a vascular depth > 0.81 cm from the skin surface (odds ratio [OR] 1.362, 95% confidence interval [CI] 1.022–2.294), arm circumference ≥ 27.35 cm (OR 1.019, 95% CI 1.022–1.163), repeated cannulations (OR 3.218, 95% CI 1.597–6.482), and multiple catheter advancements (OR 3.110, 95% CI 1.409–6.862). The nomogram incorporating these parameters demonstrated good discriminative ability (area under the curve 0.739, 95% CI 0.684–0.794) and calibration (P = 0.126, Hosmer–Lemeshow test).

Conclusions

Several parameters related to vascular morphology and procedural factors have a significant impact on the risk of CRT. The nomogram proposed here is a practical tool that can be used for individualized assessment of CRT, enabling optimized catheter management strategies.