Abstract:

Objective This study developed and validated a risk prediction model of central venous catheter-associated skin injury（CVC-CASI） in patients in the intensive care unit. Methods Using convenience sampling，clinical data were obtained for ICU patients who were admitted to a tertiary grade A hospital in Guangdong Province between January 2023 and October 2023. Independent risk factors for CVC-CASI were identified by univariate and binary logistic regression analyses. And a risk prediction model was constructed. The discrimination and calibration of the model was evaluated by the area under the receiver-operating characteristic（ROC） curve and calibration curve，and the clinical effectiveness was assessed by the clinical decision curve. Results 68 of the 434 patients who were included in the study developed CVC-CASI，giving an incidence rate of 15.7%. 74 cases of CVC-CASI occurred，with non-infectious exudation accounting for 54 cases（73.0%）. Model variables included catheter dwelling time，catheterization site，prone ventilation，skin edema，serum albumin，prothrombin time，activated partial thromboplastin time，and puncture frequency. The model validation results showed that the area under the ROC curve was 0.838（95% confidence interval 0.784-0.893） with a sensitivity of 77.9% and a specificity of 81.1%. The Youden index was 0.59. Conclusion The incidence of CVC-CASI in ICU patients is relatively high. Our prediction model has good prediction efficiency and can provide theoretical basis for early identification of high-risk populations and timely intervention for clinical medical staff.

Key words: ICU, Central Venous Catheter, Catheter-Associated Skin Injury, Prediction Model, Nomograms, Nursing Care