Development and Validation of a New Clinical Prediction Model of Catheter-Related Thrombosis Based on Vascular Ultrasound Diagnosis in Cancer Patients
Binliang Liu, Junying Xie, Xiaoying Sun, Yanfeng Wang, Žhong Yuan, Xiyu Liu, Zhou Huang, Jiani Wang, Hongnan Mo, Zongbi Yi, Xiuwen Guan, Lixi Li, Wenna Wang, Hong Li, Fei Ma, Yixin Zeng
Abstract
Background: The central venous catheter brings convenience for drug delivery and improves comfort for cancer patients, it also causes serious complications. The most common one is catheter-related thrombosis (CRT). Objectives:This study aimed to evaluate the incidence and risk factors of CRT in cancer patients and to develop an effective prediction model for CRT in cancer patients. Methods: The development of our prediction model was based on the data of a retrospective cohort (n=3131) from National Cancer Center. The validation of our prediction model was done in a prospective cohort from National Cancer Center (n=685) and a retrospective cohort from Hunan Cancer Hospital (n=61). The predictive accuracy and the discriminative ability were determined by the receiver operating characteristic 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 receiver operating characteristic (ROC) curve of our prediction model was 0.741 (CI: 0.715-0.766) in the primary cohort; 0.754 (CI: 0.704-0.803) and 0.658 (CI: 0.470-0.845) in validation cohorts respectively. Good calibration and clinical impact were also shown in primary and validation cohorts. Conclusions: Our model is a novel prediction tool for CRT risk which helps to assign cancer patients into high-risk or low-risk groups accurately. Our model will be valuable for clinicians in the decision making of thromboprophylaxis.