Nomogram prediction for the risk of medical adhesive-related skin injury at the peripherally inserted central catheter insertion site in patients with cancer

Abstract

Objective To establish a nomogram graph model to accurately predict the risk of medical adhesive-related skin injury(MARSI) at the peripherally inserted central catheter(PICC) insertion site in patients with cancer. Methods Based on data from patients with cancer in Hospital of China, the independent risk factors of MARSI at the PICC insertion site were identified by the logistic univariable and multivariable analysis and were integrated to construct a nomogram, which was validated externally.The predictive effectiveness of the nomogram was evaluated by the receiver operating characteristic curve (ROC) and calibration curve. Results A total of 352 cancer patients were included for analysis.The nomogram incorporated independent MARSI risk factors at the PICC insertion site including delayed cycle of catheter maintenance, moist skin, history of skin allergy, activated partial thromboplastin time(APTT). The C-index of the nomogram model was 0.917 and 0.864 in the training and validation cohort, respectively, demonstrating good discriminative power. The calibration plots of the nomogram revealed excellent agreement between the predicted and actual probabilities. Conclusions We established and validated a novel nomogram for predicting the risk of MARSI at the PICC insertion site in patients with cancer. The nomogram model could precisely estimate the MARSI risk at the PICC insertion siteof cancer patients and identify high-risk patients who are in need of a specific treatment strategy.