Abstract:

Objective To establish a risk prediction model for the occurrence of venous thromboembolism（VTE） in hospitalized children and to validate the application of the model. Methods Retrospective analysis was conducted on 62 children who developed VTE during hospitalization in our hospital from January 2022 to July 2023 and were selected in a VTE group. In the ratio of 1：4，248 children from the same department and time who did not develop VTE were selected in a non-VTE group. Logistic regression analysis was used to develop the risk prediction model. Hosmer-Lemeshow test and receiver operator characteristic（ROC） curves were used to test the goodness of fit and predictive effectiveness of the model. Bootstrap self-help method was used for the internal validation of the model by re-sampling the sample 1，000 times. Results In our study，the incidence of VTE was 0.43‰. Logistic regression analysis showed that the length of central venous access device（PICC） stay ≥3 d，stay with fully implantable intravenous port，chemotherapy，ICU length of stay ≥4 d，and bracing duration >72 h were the independent risk factors for the development of VTE in hospitalized children（P<0.05）. Hosmer-Lemeshow test showed that χ²=5.291，P=0.152. Sensitivity was 0.857，specificity was 0.218，and area under the ROC curve was 0.823 by Bootstrap self-help method resampling method. Conclusion The risk predictive model of VTE risk in hospitalized children constructed in this study has good predictive performance，which can be used for clinical medical staff to identify children at high risk of VTE at an early stage and take preventive measures.

Key words: Venous Thromboembolism, Risk Factors, Prediction Model, Pediatric Nursing

摘要：

目的 构建住院患儿静脉血栓栓塞症（venous thromboembolism，VTE）风险预测模型，并验证模型的预测效果。 方法 回顾性选取2022年1月—2023年7月在武汉市某三级甲等儿童专科医院住院且发生VTE的62例患儿作为VTE组，按照1 ∶ 4的比例选择同时间段在同科室住院且未发生VTE的248例患儿作为非VTE组，采用Logistic回归分析建立风险预测模型，采用Hosmer-Lemeshow检验和受试者操作特征（receiver operator characteristic，ROC）曲线分别检验模型的拟合优度及预测效果，采用Bootstrap自助法重抽样1 000次对模型进行内部验证。 结果 研究期间，VTE发生率为0.43‰。Logistic回归分析显示，PICC留置时长≥3 d、留置完全植入式静脉输液港、化疗、ICU住院时长≥4 d、制动时长>72 h是住院患儿发生VTE的独立危险因素（P<0.05）。Hosmer-Lemeshow检验结果显示，χ²=5.291，P=0.152。Bootstrap自助法重抽样结果显示，模型的灵敏度为0.857，特异度为0.218，ROC曲线下面积为0.823。 结论 该研究构建的住院患儿VTE风险预测模型具有良好的预测效能，可为护理人员早期识别VTE高风险患儿、及时采取预防措施提供依据。

关键词: 静脉血栓栓塞症, 危险因素, 预测模型, 儿科护理学