Construction and verification of risk prediction model of mechanical phlebitis after PICC implantation

XIE Qiaoqing; HE Chunmei; HUANG Kezhi; CHEN Yongwen; LUO Mei; HE Meiqun; LI Zhiying

doi:10.12102/j.issn.2095-8668.2025.04.019

Abstract：Objective: To investigate the risk factors for mechanical phlebitis after peripherally inserted central catheter (PICC) placement in newborns, and to construct a nomogram prediction model. Methods: A total of 284 newborns who underwent PICC placement at our hospital between January 2022 and June 2023 were selected as the study subjects, and were divided into two groups based on whether mechanical phlebitis occurred: the phlebitis group (43 cases) and the non-phlebitis group (241 cases). Logistic regression analysis was used to screen the risk factors for mechanical phlebitis after PICC placement in newborns, and a risk prediction model was constructed. Results: Among the 284 newborns who underwent PICC placement, 43 developed mechanical phlebitis, with an incidence rate of 15.14%. Logistic regression analysis showed that the weight at the time of catheterization, the number of punctures, and the position of the catheter tip were influencing factors for mechanical phlebitis after PICC placement in newborns (P < 0.05). Based on these factors, a nomogram risk prediction model for mechanical phlebitis after PICC placement in newborns was constructed. The concordance index (C-index) was 0.741 [95% CI (0.697, 0.842)], and the area under the receiver operating characteristic curve (AUC) was 0.741 [95% CI (0.667, 0.816), P < 0.05]. The application results showed that the model had a prediction accuracy of 96.00%, indicating a high level of discrimination. Conclusion: Low birth weight, more than one puncture attempt, and catheter malposition are independent risk factors for mechanical phlebitis after PICC placement in newborns. This study constructed a risk prediction model for mechanical phlebitis after PICC placement in newborns, which can provide prospective guidance for clinical staff to take intervention strategies, thereby improving the complications associated with PICC placement in newborns.