Development and Validation of a New Clinical Prediction Model of Catheter-Related Thrombosis Based on Vascular Ultrasound Diagnosis in Cancer Patients

Abstract

Background: Central venous catheters are convenient for drug delivery and improved comfort for cancer patients, but they also cause serious complications. The most common complication is catheter-related thrombosis (CRT). Objectives: This study aimed to evaluate the incidence and risk factors for CRT in cancer patients and develop an effective prediction model for CRT in cancer patients. Methods: The development of our prediction model was based on a retrospective cohort (n = 3,131) from the National Cancer Center. Our prediction model was confirmed in a prospective cohort from the National Cancer Center (n = 685) and a retrospective cohort from the Hunan Cancer Hospital (n = 61). The predictive accuracy and discriminative ability were determined by receiver operating characteristic (ROC) curves and calibration plots. Results: Multivariate analysis demonstrated that sex, cancer type, catheter type, position of the catheter tip, chemotherapy status, and antiplatelet/anticoagulation status at baseline were independent risk factors for CRT. The area under the ROC curve of our prediction model was 0.741 (CI: 0.715-0.766) in the primary cohort and 0.754 (CI: 0.704-0.803) and 0.658 (CI: 0.470-0.845) in validation cohorts 1 and 2, respectively. The model also showed good calibration and clinical impact in the primary and validation cohorts. Liu et al. CRT Prediction Model in Cancer Conclusions: Our model is a novel prediction tool for CRT risk that accurately assigns cancer patients into high-and low-risk groups. Our model will be valuable for clinicians when making decisions regarding thromboprophylaxis.

Development and validation of a prediction model of catheter-related thrombosis in patients with cancer undergoing chemotherapy based on ultrasonography results and clinical information

“…Nomograms are important in modern medical decision-making models because of their high accuracy and good discriminative capability [ 21 , 28 , 29 ]. At present, several models are being used to predict VTE in patients with cancer [ 21 , 23 , 28 , 30 ]. However, these models did not consider the risk factors associated with vascular ultrasound features.…”

Conditional catheter‐related thrombosis free probability and risk‐adapted choices of catheter for lung cancer

“…There have been previous studies on risk prediction models for CRT 10,31,32 . However, some of the risk covariates in these models were unsuitable for lung cancer patients.…”

“…There have been previous studies on risk prediction models for CRT. 10 , 31 , 32 However, some of the risk covariates in these models were unsuitable for lung cancer patients. In addition, these analyses were based on proportional hazard models and implicitly assumed a constant risk of covariates.…”

Clinical Nurses’ Knowledge, Attitude and Practice of Catheter-Related Thrombosis and Its Influencing Factors: A Cross-Sectional Survey

“…Catheter-related thrombosis (CRT) is venous thromboembolism (VTE) related to venous catheters, 1 it refers to the venous blood clot formation in the vessel and vessel wall where the catheter is located because of a puncture or mechanical injury of the vessel intima or the patient’s disease. 2 With the rapid development of intravenous infusion technology, central venous catheterization has become one of the indispensable technologies in modern medicine. Central venous catheter (CVC), peripherally inserted central venous catheter (PICC), and infusion port (PORT) have established effective venous treatment channels for patients in first aid, intensive care, and chemotherapy.…”

“… 4 , 5 Once the thrombus falls off, it will migrate to the pulmonary artery with blood flow, leading to pulmonary embolism and affection. 2 Research shows that the risk factors of CRT involve multiple dimensions of patients, operators, and catheters. The average time of occurrence is 10 days, and the diagnostic time of most CRT is within 100 days, and the incidence of CRT reported in domestic and foreign literature is 16 ~ 66%, 6 which is related to the different study design, study population, catheter type, and location, retention time, follow-up time, diagnostic methods, etc.…”