Construction and validation of a risk prediction model for double-lumen central venous catheter dysfunction in critically ill patients
JIA Xiufen
LIU Yuping
GAO Jing
CHEN Cui
ZHANG Juan
JIANG Li
ZHANG Yandan
ZHANG Juanjuan
ZHANG Jie
Abstract：Objective:To construct and validate a risk prediction model for dysfunction of double-lumen central venous catheters in critically ill patients.Methods:A convenience sampling method was used to select 635 patients with double-lumen central venous catheters in the intensive care unit of a tertiary hospital from December 2023 to March 2024.Clinical data were collected,and catheter function was routinely assessed daily.Univariate analysis and Logistic regression analysis were used to identify influencing factors for catheter dysfunction in critically ill patients.Based on these factors,a risk prediction model for catheter dysfunction was constructed.The Hosmer-Lemeshow test and the area under the receiver operating characteristic(ROC)curve(AUC)were used to evaluate the model's fit and predictive performance.Results:The incidence of double-lumen central venous catheter dysfunction in critically ill patients was 38.97%.Logistic regression analysis revealed that COPD[OR=3.336,95%CI(1.359,8.337),P<0.05],D-dimer concentration[OR=1.125,95%CI(1.077,1.175),P<0.001],and improper flushing and sealing of the catheter[OR=1.784,95%CI(1.091,2.918),P<0.05]were independent risk factors for catheter dysfunction.The Hosmer-Lemeshow test showed χ2=14.097,P=0.079,and AUC was 0.735[95%CI(0.686,0.784),P<0.001],the optimal critical value was 0.375,the sensitivity was 0.569 and the specificity was 0.806.The results of validation showed that the sensitivity was 0.632,the specificity was 0.736,and the accuracy rate was 80.90%.Conclusion:The risk prediction model for double-lumen central venous catheter dysfunction in critically ill patients has a small number of items and good predictive performance,providing a reference for the rapid clinical screening of high-risk patients for catheter dysfunction.
Keywords：double-lumen central venous catheterdysfunctionrisk prediction modelrisk factorscritically ill patientsnursing
Publication Date：2025-02-27
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：6( 714-719 )