Construction and verification of a risk prediction model for venous inflammation in preterm neonates with PICC placed in lower limbs

doi:10.3761/j.issn.0254-1769.2026.02.006

Abstract

Abstract:

Objective To analyze the influencing factors of phlebitis in premature infants undergoing peripherally inserted central catheter（PICC） placement via the lower limb，construct and validate a risk prediction model，and provide references for early identification and prevention of phlebitis. Methods Using a convenience sampling method，366 premature infants who underwent lower limb PICC placement in a tertiary general hospital in Nanjing between January 2019 and December 2022 were selected as a modeling group. A total of 158 premature infants who underwent the same procedure between January 2023 and December 2024 were selected as a validation group. Relevant data were collected retrospectively. Logistic regression analysis was used to identify the influencing factors of phlebitis in premature infants with lower limb PICC placement，based on which a risk prediction model was constructed and its predictive performance evaluated. Results In the modeling group，97 cases developed phlebitis，with an incidence rate of 26.50%. Logistic regression analysis indicated that gestational age，infusion of irritant drugs，punctured vein，puncture site，total puncture duration，and number of dressing changes within 7 days after puncture were significant influencing factors（P<0.05）. Based on these results，a risk prediction model was established. In the validation group，the optimal cut-off value of the model was 0.311，with an accuracy of 92%，sensitivity of 94%，specificity of 88%，positive predictive value of 0.94，and negative predictive value of 0.86. Hosmer-Lemeshow test results showed χ²=8.100（P=0.424）. Conclusion The risk prediction model for phlebitis in premature infants undergoing lower limb PICC placement demonstrates good discrimination and calibration，and can provide references for neonatal nurses to predict related risks.

Key words: Peripherally Inserted Central Catheter, Veins of the Lower Limb, Phlebitis, Preterm Infant, Risk Prediction Model, Nursing Care

摘要：

目的分析早产儿经下肢置入PICC并发静脉炎的影响因素，构建并验证风险预测模型，为早期识别及预防静脉炎提供参考。方法采用便利抽样法，选取2019年1月—2022年12月在南京市某三级甲等综合医院行下肢PICC置管的366例早产儿作为建模组，选取2023年1月—2024年12月行下肢PICC置管的158例早产儿作为验证组，回顾性收集相关资料，采用Logistic回归分析探究早产儿经下肢置入PICC并发静脉炎的影响因素，构建风险预测模型，并评价其预测效果。结果在建模组中有97例发生了静脉炎，发生率为26.50%。Logistic回归分析结果显示，胎龄、是否输注刺激性药物、穿刺静脉、穿刺部位、穿刺总时长、穿刺后7 d内更换敷料的次数是早产儿经下肢置入PICC并发静脉炎的影响因素（P<0.05）。依据以上结果构建风险预测模型，验证组中，模型的最佳截断值为0.311，准确率为92%，灵敏度为94%，特异度为88%，阳性预测值为0.94，阴性预测值为0.86；Hosmer-Lemeshow检验结果显示，χ²=8.100（P=0.424）。结论早产儿经下肢置入PICC并发静脉炎风险预测模型具有良好的区分度、校准度，可为新生儿科护士预测相关风险提供参考。

关键词: 经外周置入中心静脉导管, 下肢静脉, 静脉炎, 早产儿, 风险预测模型, 护理

LI Fang, XU Cuirong, JIANG Lin, ZHANG Lixia, XIAO Yanhua, YUAN Xiao, HUANG Chaoyang, BAO Jiawei. Construction and verification of a risk prediction model for venous inflammation in preterm neonates with PICC placed in lower limbs[J]. Chinese Journal of Nursing, 2026, 61(2): 190-197.

李昉, 徐翠荣, 姜琳, 张李霞, 肖艳华, 原晓, 黄朝阳, 包佳威. 早产儿经下肢置入PICC并发静脉炎风险预测模型的构建与验证[J]. 中华护理杂志, 2026, 61(2): 190-197.

Figures/Tables 5

Table 1 General information of the survey subjects and the results of univariate analysis of phlebitis complicated by PICC inserted via the lower limbs

Table 2 Results of Logistic regression analysis on risk factors for phlebitis complicated by PICC inserted via lower limbs in preterm infants（n=366）

Figure 1 Nomogram for predicting phlebitis risk in preterm infants with lower limb PICC

Figure 2 Receiver operating charac-teristic curve of the prediction model for phlebitis following lower limb PICC insertion in preterm infants

Figure 3 Decision curve analysis of the prediction model for phlebitis following lower limb PICC insertion in preterm infants

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