Development of a risk prediction model for central venous catheter insertion-related thrombosis in critically ill pediatric patients.

Introduction: Central venous catheter-related thrombosis (CVC-RT) is a serious complication associated with CVC insertion that significantly adversely affects the prognosis of critically ill children. This study aimed to identify risk factors for CVC-RT following CVC placement in critically ill children and to develop a corresponding risk prediction model. Methods: A total of 188 critically ill children with CVCs were enrolled and categorized into thrombosis and non-thrombosis groups. Clinical data were collected to analyze risk factors for CVC-RT, and a nomogram prediction model was developed and validated for its predictive performance. Results: Among the 188 children, 31 developed CVC-RT, yielding an incidence rate of 16.5%. Significant differences were observed between the two groups in terms of age, catheter type, parenteral nutrition status, D-dimer levels, and fibrinogen (FIB) levels. All of these factors, except catheter type, were identified as independent predictors of CVC-RT. The constructed nomogram prediction model demonstrated strong predictive performance and discriminative ability, with an area under the receiver operating characteristic curve of 0.952. Discussion: In summary, this study identified age, parenteral nutrition, D-dimer, and FIB levels as independent influencing factors for CVC-RT in critically ill children. The nomogram model incorporating these factors exhibited favorable predictive value.