关键词: 中心静脉导管相关性血栓, 预测模型, 系统评价, 循征护理学

Abstract:

Objective To systematically analyze and evaluate the prediction models for central venous catheter-associated thrombosis，in order to provide references for constructing higher quality risk prediction models for central venous catheter-associated thrombosis. Methods Original articles in Chinese and English were systematically searched from Chinese databases（CNKI，Wanfang，Sinomed） and English databases（PubMed，Embase，Web of Science，Cochrane Library，CINAHL），and the search period was from the database establishment to February 16，2022.There were 2 investigators who independently screened the literature and extracted data，and applied PROBAST，a risk of bias assessment tool for predictive modeling studies，to analyze the risk of bias and applicability of the included literature. Results A total of 15 studies were included to construct risk prediction models for central venous catheter-associated thrombosis, involving a total of 16 models. 156 models had an area under the subject operating characteristic curve ranging from 0.641 to 0.85. 12 studies had good applicability，while the remaining 3 studies had poor applicability. 15 studies had a high risk of bias，mainly due to failure to select appropriate data sources，inappropriate inclusion and exclusion criteria for study subjects，insufficient sample size，inadequate treatment of missing data，unreasonable variable screening process， consideration of competing risk factors，lack of model performance.The risk of bias was high in all 15 studies，mainly due to inappropriate selection of data sources，inappropriate inclusion and exclusion criteria, incomplete exclusion of predictors from outcome indicators，insufficient sample size，unreasonable treatment of continuous variables，insufficient attention to missing data，unreasonable variable screening process，consideration of competing risk factors，lack of model performance evaluation and over-simulation of the model，etc. Conclusion The construction of existing risk prediction models for central venous catheter-associated thrombosis is still in its initial stage.It is necessary to focus on the study of the validity of different risk assessment methods in the later construction in order to obtain better and highly accurate risk prediction models and provide certain references and bases for the development of relevant prevention strategies.

Key words: Central Venous Catheter-Associated Thrombosis, Prediction Model, Systematic Review, Evidence-Based Nursing