Risk identification of secondary displacement of PICC catheters in very low birth weight infants based on weight growth trajectories

ObjectiveTo identify growth trajectory of weight by using latent class growth modeling,and to analyze the risk of secondary PICC catheter displacement in very low birth weight(VLBW) infants with different trajectories.MethodsBy a convenience sampling method,very low birth weight infants who underwent PICC placement admitted to Shanxi Bethune Hospital from January 2022 to December 2024 were selected as the survey subjects.Latent class growth modeling was used to identify the weight growth trajectory of the infants after catheterization for 4 weeks.Multivariate Cox regression analysis was used to identify the risk factors for secondary catheter displacement in the infants.The survival curves were drawn to compare the occurrence of secondary catheter displacement in infants with different weight growth trajectories.ResultsA total of 212 very low birth weight infants were included.According to their weight growth trajectory after catheterization,they were divided into three types:decline⁃then⁃rise type(38.2%),rise⁃then⁃decline type(17.5%),and relatively stable type(44.3%).Multivariate Cox regression analysis results showed that decline⁃then⁃rise type[HR=4.290,95%CI (1.853,9.923)],and rise⁃then⁃decline type[HR=3.399,95%CI(1.352,8.535)]were risk factors for secondary catheter displacement in very low birth weight infants.The survival curve results showed that with the relatively stable type as a reference,the risk of catheter displacement was higher in the decline⁃then⁃rise type(χ2=6.786,P=0.005) and rise⁃then⁃decline type(χ2=9.861,P<0.05).There was no statistically significant difference in terms of the risk of catheter displacement between the decline⁃then⁃rise type and the rise⁃then⁃decline type(χ2=0.507,P=0.476).ConclusionsThe weight growth trajectory of very low birth weight infants after catheterization included three types:decline⁃then⁃rise type,rise⁃then⁃decline type,and relatively stable type.Decline⁃then⁃rise type and rise⁃then⁃decline type are risk factors for secondary catheter displacement in very low birth weight infants.Risk stratification of PICC catheter secondary displacement based on different weight growth trajectories could provide a basis for early intervention by medical staff.