Study on the influencing factors of unplanned extubation of PICC in 7 298 patients with hematological diseases
10.3969/j.issn.1671-8348.2024.02.015
- VernacularTitle:7 298例血液病患者PICC非计划拔管的影响因素研究
- Author:
Junxia WANG
1
,
2
;
Huimin ZHANG
;
Miaomiao YANG
;
Mengchuan WANG
;
Yuwen CHEN
;
Li XU
Author Information
1. 中国医学科学院血液病医院(中国医学科学院血液学研究所)/实验血液学国家重点实验室/国家血液系统疾病临床医学研究中心/细胞生态海河实验室,天津 300020
2. 天津医学健康研究院,天津 301600
- Keywords:
patients with hematologic diseases;
peripherally inserted central catheter;
unplanned extu-bation;
restricted cubic spline
- From:
Chongqing Medicine
2024;53(2):239-245
- CountryChina
- Language:Chinese
-
Abstract:
Objective To analyze the influencing factors of unplanned extubation(UE)occurrence of peripherally inserted central catheter(PICC)in the patients with hematological diseases.Methods A retro-spective cohort study method was adopted.The data of 7 298 patients with hematological diseases implanted with PICC catheter and followed up to its removal from January 1,2016 to December 31,2020 in the Hematol-ogy Hospital of Chinese Academy of Medical Sciences were collected,including the demographic information,catheterization records,maintenance and extubation records.According to whether UE occurring,they were divided into the UE group(n=262)and normal extubation group(n=7 036).The general data were com-pared between the two groups.The COX regression was used to analyze the influencing factors of UE in pa-tients with hematological diseases.The dose-effect relationship between age and PICC UE occurrence risk was studied by the restrictive cubic spline method.Results The incidence rate of UE was 3.6％(262/7 298).The COX regression analysis results showed that the gender,disease diagnosis,fibrinogen,prothrombin time,PLT,catheter material,number of punctures during catheterization,positioning method of catheter tip,num-ber of catheter-related complications occurrence were related to PICC UE occurrence in the patients with he-matological diseases(P＜0.05).The results of restricted cubic spline showed that there was a"U"-type non-linear relationship between age and UE risk(X2=17.710,P＜0.05),and the risk of UE was the lowest when the age was 30 years old.Conclusion In PICC,the emphasis should be paid to the male patients with hemato-logical malignancies who have repeated punctures during catheterization,no intracardiac electrocardiographic positioning during catheterization,bleeding tendency,indwelling polyurethane catheters and repeated catheter-related complications in order to decrease the UC occurrence probability.
