Predictive model for CRT risk in cancer patients with central venous access devices: a systematic review and meta-analysis
IntroductionWith the high incidence of central venous access device catheter-related thrombosis (CRT) in patients with cancer, its early onset, and the characteristics of clinically insignificant symptoms, risk assessment is essential for the targeted application of thromboprophylaxis. The aim of th...
Saved in:
| Main Authors: | , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Frontiers Media S.A.
2025-06-01
|
| Series: | Frontiers in Medicine |
| Subjects: | |
| Online Access: | https://www.frontiersin.org/articles/10.3389/fmed.2025.1580920/full |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1849424147260637184 |
|---|---|
| author | Wenjuan Yang Meng Fang Kangqin Cai Qin Pan Cheng Zhang Jiquan Zhang |
| author_facet | Wenjuan Yang Meng Fang Kangqin Cai Qin Pan Cheng Zhang Jiquan Zhang |
| author_sort | Wenjuan Yang |
| collection | DOAJ |
| description | IntroductionWith the high incidence of central venous access device catheter-related thrombosis (CRT) in patients with cancer, its early onset, and the characteristics of clinically insignificant symptoms, risk assessment is essential for the targeted application of thromboprophylaxis. The aim of this paper was to review the risk prediction models developed for central venous access device CRT in patients with cancer and to evaluate their performance.MethodsPubMed, Embase, Web of Science, Cochrane Library, CNKI, SinoMed, Wanfang Data, and VIP databases were searched, and the search timeframes ranged from the establishment of the database to May 22, 2024. Two researchers independently performed literature screenings, data extractions, and quality assessments. The risk of bias and applicability of the included studies were assessed using the Predictive Model Risk of Bias Assessment Tool. A meta-analysis of the areas under the curve (AUC) values for model validation was performed using Stata 17.0 software.ResultsNineteen papers with 29 predictive models were included in this systematic review, reporting AUC values of 0.470–1.000. The incidence of central venous access device CRT in cancer patients ranges from 2.02 to 39.4%. The most commonly used predictors are D-dimer levels, BMI, and diabetes. All studies were judged to have a high risk of bias, mainly due to poor reporting of the areas analyzed. The combined AUC value of the six validated models was 0.81 (95% confidence interval: 0.76–0.86), indicating good model discrimination.DiscussionMost available CRT prediction models exhibited moderate-to-good predictive performance. However, all the studies were rated as having a high risk of bias according to the PROBAST scale. Future studies should adhere to methodological and reporting guidelines for large-sample, multi-center external validation of models, focusing on studies that report rigorous design and optimization or on the development of new models.Systematic review registrationPROSPERO, identifier: CRD42024516563. |
| format | Article |
| id | doaj-art-ea05e15b18014d65a996f5d1a7b20867 |
| institution | Kabale University |
| issn | 2296-858X |
| language | English |
| publishDate | 2025-06-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Medicine |
| spelling | doaj-art-ea05e15b18014d65a996f5d1a7b208672025-08-20T03:30:19ZengFrontiers Media S.A.Frontiers in Medicine2296-858X2025-06-011210.3389/fmed.2025.15809201580920Predictive model for CRT risk in cancer patients with central venous access devices: a systematic review and meta-analysisWenjuan Yang0Meng Fang1Kangqin Cai2Qin Pan3Cheng Zhang4Jiquan Zhang5Department of Nephrology, Zigong First People's Hospital, Zigong, Sichuan, ChinaDepartment of Cardiovascular Medicine, Zigong First People's Hospital, Zigong, Sichuan, ChinaDepartment of Nephrology, Zigong First People's Hospital, Zigong, Sichuan, ChinaDepartment of Nephrology, Zigong First People's Hospital, Zigong, Sichuan, ChinaEmergency Department, Handan Central Hospital, Handan, Hebei, ChinaDepartment of Nephrology, Deyang People's Hospital, Deyang, Sichuan, ChinaIntroductionWith the high incidence of central venous access device catheter-related thrombosis (CRT) in patients with cancer, its early onset, and the characteristics of clinically insignificant symptoms, risk assessment is essential for the targeted application of thromboprophylaxis. The aim of this paper was to review the risk prediction models developed for central venous access device CRT in patients with cancer and to evaluate their performance.MethodsPubMed, Embase, Web of Science, Cochrane Library, CNKI, SinoMed, Wanfang Data, and VIP databases were searched, and the search timeframes ranged from the establishment of the database to May 22, 2024. Two researchers independently performed literature screenings, data extractions, and quality assessments. The risk of bias and applicability of the included studies were assessed using the Predictive Model Risk of Bias Assessment Tool. A meta-analysis of the areas under the curve (AUC) values for model validation was performed using Stata 17.0 software.ResultsNineteen papers with 29 predictive models were included in this systematic review, reporting AUC values of 0.470–1.000. The incidence of central venous access device CRT in cancer patients ranges from 2.02 to 39.4%. The most commonly used predictors are D-dimer levels, BMI, and diabetes. All studies were judged to have a high risk of bias, mainly due to poor reporting of the areas analyzed. The combined AUC value of the six validated models was 0.81 (95% confidence interval: 0.76–0.86), indicating good model discrimination.DiscussionMost available CRT prediction models exhibited moderate-to-good predictive performance. However, all the studies were rated as having a high risk of bias according to the PROBAST scale. Future studies should adhere to methodological and reporting guidelines for large-sample, multi-center external validation of models, focusing on studies that report rigorous design and optimization or on the development of new models.Systematic review registrationPROSPERO, identifier: CRD42024516563.https://www.frontiersin.org/articles/10.3389/fmed.2025.1580920/fullcatheter-related thrombosis (CRT)central venous access devicescancer patientsrisk prediction modelsmeta-analysis |
| spellingShingle | Wenjuan Yang Meng Fang Kangqin Cai Qin Pan Cheng Zhang Jiquan Zhang Predictive model for CRT risk in cancer patients with central venous access devices: a systematic review and meta-analysis Frontiers in Medicine catheter-related thrombosis (CRT) central venous access devices cancer patients risk prediction models meta-analysis |
| title | Predictive model for CRT risk in cancer patients with central venous access devices: a systematic review and meta-analysis |
| title_full | Predictive model for CRT risk in cancer patients with central venous access devices: a systematic review and meta-analysis |
| title_fullStr | Predictive model for CRT risk in cancer patients with central venous access devices: a systematic review and meta-analysis |
| title_full_unstemmed | Predictive model for CRT risk in cancer patients with central venous access devices: a systematic review and meta-analysis |
| title_short | Predictive model for CRT risk in cancer patients with central venous access devices: a systematic review and meta-analysis |
| title_sort | predictive model for crt risk in cancer patients with central venous access devices a systematic review and meta analysis |
| topic | catheter-related thrombosis (CRT) central venous access devices cancer patients risk prediction models meta-analysis |
| url | https://www.frontiersin.org/articles/10.3389/fmed.2025.1580920/full |
| work_keys_str_mv | AT wenjuanyang predictivemodelforcrtriskincancerpatientswithcentralvenousaccessdevicesasystematicreviewandmetaanalysis AT mengfang predictivemodelforcrtriskincancerpatientswithcentralvenousaccessdevicesasystematicreviewandmetaanalysis AT kangqincai predictivemodelforcrtriskincancerpatientswithcentralvenousaccessdevicesasystematicreviewandmetaanalysis AT qinpan predictivemodelforcrtriskincancerpatientswithcentralvenousaccessdevicesasystematicreviewandmetaanalysis AT chengzhang predictivemodelforcrtriskincancerpatientswithcentralvenousaccessdevicesasystematicreviewandmetaanalysis AT jiquanzhang predictivemodelforcrtriskincancerpatientswithcentralvenousaccessdevicesasystematicreviewandmetaanalysis |