Chang Meifang, Zhu Xiaming, Liu Minghong, Mao Yanqin, Wu Qian
Department of Hematology, The First Affiliated Hospital of Soochow University, Suzhou City, Jiangsu Province, China.
Medicine (Baltimore). 2025 Jan 10;104(2):e41181. doi: 10.1097/MD.0000000000041181.
This study analyzes the prognostic factors of thrombosis in patients with hematological diseases after peripherally inserted central catheter (PICC) surgery. We conducted a retrospective analysis of 223 patients with hematological diseases who underwent PICC catheterization between January 2017 and June 2021. These patients were categorized into the thrombotic group and non-thrombotic group based on the occurrence of thrombosis following PICC catheterization. Subsequently, we identified influencing factors for thrombosis in patients with hematological diseases after PICC catheterization using univariate and multivariate logistic regression. Furthermore, we drew the ROC curve and calculated the AUC value to obtain the ideal critical value for predicting thrombosis risk in these patients. After PICC catheterization in 223 patients with hematological tumors, 107 cases developed thrombosis. The univariate analysis revealed significant differences in age, catheter placement, catheter-related complications (infection), the proportion of underlying diseases, and coagulation-related indicators between the 2 groups. Furthermore, the multivariate analysis demonstrated that catheter infection, diabetes, history of thrombosis, fibrinogen degradation products (FDP), antithrombin III (AT-III) and D-dimer were all independent factors of thrombosis in patients with hematological diseases after PICC. The AUC areas of the working characteristic curves of FDP, AT-III, and D-dimer in predicting post PICC thrombosis in patients with hematological diseases were 0.744, 0.651, and 0.595, respectively. Hematological diseases patients with catheter infection, diabetes, history of thrombosis, FDP > 3.24 mg/L, AT-III < 93%, or D-dimer > 2.41 µg/mL are prone to thrombosis after PICC surgery.
本研究分析血液系统疾病患者经外周静脉穿刺中心静脉置管（PICC）术后血栓形成的预后因素。我们对2017年1月至2021年6月期间接受PICC置管的223例血液系统疾病患者进行了回顾性分析。根据PICC置管后是否发生血栓，将这些患者分为血栓形成组和非血栓形成组。随后，我们采用单因素和多因素logistic回归分析确定血液系统疾病患者PICC置管后血栓形成的影响因素。此外，我们绘制ROC曲线并计算AUC值，以获得预测这些患者血栓形成风险的理想临界值。223例血液系统肿瘤患者PICC置管后，107例发生血栓。单因素分析显示，两组患者在年龄、导管置入部位、导管相关并发症（感染）、基础疾病比例以及凝血相关指标方面存在显著差异。此外，多因素分析表明，导管感染、糖尿病、血栓形成史、纤维蛋白原降解产物（FDP）、抗凝血酶III（AT-III）和D-二聚体均为血液系统疾病患者PICC术后血栓形成的独立因素。FDP、AT-III和D-二聚体预测血液系统疾病患者PICC术后血栓形成的工作特征曲线的AUC面积分别为0.744、0.651和0.595。导管感染、糖尿病、血栓形成史、FDP>3.24mg/L、AT-III<93%或D-二聚体>2.41μg/mL的血液系统疾病患者PICC术后易发生血栓。
