Development and validation of a nomogram incorporating vascular morphological parameters for prediction of peripherally inserted central catheter-related thromboembolism in cancer patients.
- 1Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), ICU, Peking University Cancer Hospital & Institute, No. 52 Fucheng Road, Haidian District, Beijing, 100142, China.
- 2Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), ICU-VAC, Peking University Cancer Hospital & Institute, No. 52 Fucheng Road, Haidian District, Beijing, China.
- 3Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), ICU, Peking University Cancer Hospital & Institute, No. 52 Fucheng Road, Haidian District, Beijing, 100142, China. [email protected].
Abstract
Background
Peripherally inserted central catheter (PICC)-related thrombosis (CRT) is a critical complication in cancer patients. However, the impact of vascular morphological parameters on the risk of this complication remains poorly understood. This study aimed to identify independent risk factors associated with vascular morphology and develop a nomogram for predicting CRT.Methods
Cancer patients who underwent placement of a PICC at a tertiary hospital between 2021 and 2023 were retrospectively identified. Vascular parameters (vessel depth, vessel diameter, arm circumference) and procedural factors (cannulation/attempts, catheter tip position) were assessed by ultrasonography. Independent risk factors for CRT were identified by multivariate logistic regression and Cox proportional hazards models. A nomogram was constructed using the rms package in R. Discrimination was evaluated via the area under the curve and calibration by the Hosmer-Lemeshow goodness-of-fit test.Results
A PICC was placed in 2,183 cancer patients during the study period. CRT occurred in 102 (4.7%) of these patients. Independent risk factors identified were a vascular depth > 0.81 cm from the skin surface (odds ratio [OR] 1.362, 95% confidence interval [CI] 1.022-2.294), arm circumference ≥ 27.35 cm (OR 1.019, 95% CI 1.022-1.163), repeated cannulations (OR 3.218, 95% CI 1.597-6.482), and multiple catheter advancements (OR 3.110, 95% CI 1.409-6.862). The nomogram incorporating these parameters demonstrated good discriminative ability (area under the curve 0.739, 95% CI 0.684-0.794) and calibration (P = 0.126, Hosmer-Lemeshow test).Conclusions
Several parameters related to vascular morphology and procedural factors have a significant impact on the risk of CRT. The nomogram proposed here is a practical tool that can be used for individualized assessment of CRT, enabling optimized catheter management strategies.
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BibTeX
@article{wang2026development,
title = {{Development and validation of a nomogram incorporating vascular morphological parameters for prediction of peripherally inserted central catheter-related thromboembolism in cancer patients.}},
author = {Guodong Wang and Yanfen Shen and Xinpeng Wang and Jie Chen and Jing Dong and Xiaozheng Wang and Yuanyuan Zheng and Xiaofang Meng and Feng Liu and Jun Dong},
journal = {Thrombosis journal},
year = {2026},
month = aug,
doi = {10.1186/s12959-026-00903-3},
url = {https://europepmc.org/article/MED/42958275},
note = {CC BY-NC-ND},
}
RIS
TY - JOUR
TI - Development and validation of a nomogram incorporating vascular morphological parameters for prediction of peripherally inserted central catheter-related thromboembolism in cancer patients.
AU - Guodong Wang
AU - Yanfen Shen
AU - Xinpeng Wang
AU - Jie Chen
AU - Jing Dong
AU - Xiaozheng Wang
AU - Yuanyuan Zheng
AU - Xiaofang Meng
AU - Feng Liu
AU - Jun Dong
PY - 2026
DA - 2026/08/04
JO - Thrombosis journal
DO - 10.1186/s12959-026-00903-3
UR - https://europepmc.org/article/MED/42958275
AB - Background Peripherally inserted central catheter (PICC)-related thrombosis (CRT) is a critical complication in cancer patients. However, the impact of vascular morphological parameters on the risk of this complication remains poorly understood. This study aimed to identify independent risk factors associated with vascular morphology and develop a nomogram for predicting CRT.Methods Cancer patients who underwent placement of a PICC at a tertiary hospital between 2021 and 2023 were retrospectively identified. Vascular parameters (vessel depth, vessel diameter, arm circumference) and procedural factors (cannulation/attempts, catheter tip position) were assessed by ultrasonography. Independent risk factors for CRT were identified by multivariate logistic regression and Cox proportional hazards models. A nomogram was constructed using the rms package in R. Discrimination was evaluated via the area under the curve and calibration by the Hosmer-Lemeshow goodness-of-fit test.Results A PICC was placed in 2,183 cancer patients during the study period. CRT occurred in 102 (4.7%) of these patients. Independent risk factors identified were a vascular depth > 0.81 cm from the skin surface (odds ratio [OR] 1.362, 95% confidence interval [CI] 1.022-2.294), arm circumference ≥ 27.35 cm (OR 1.019, 95% CI 1.022-1.163), repeated cannulations (OR 3.218, 95% CI 1.597-6.482), and multiple catheter advancements (OR 3.110, 95% CI 1.409-6.862). The nomogram incorporating these parameters demonstrated good discriminative ability (area under the curve 0.739, 95% CI 0.684-0.794) and calibration (P = 0.126, Hosmer-Lemeshow test).Conclusions Several parameters related to vascular morphology and procedural factors have a significant impact on the risk of CRT. The nomogram proposed here is a practical tool that can be used for individualized assessment of CRT, enabling optimized catheter management strategies.
SN - 1477-9560
ER -