Abstract: Objective To analyze the risk factors associated with blood oozing at peripherally inserted central catheter (PICC) puncture sites in elderly patients with hematological diseases. Methods We retrospectively investigated clinical data from 238 PICC patients, with multi-dimensional indicators including coagulation, nutrition, inflammation, vascular metabolism, and puncture procedure collected. Univariate and multivariate logistic regression analyses were used to identify the influencing factors of puncture site oozing. The Hosmer-Lemeshow test and receiver operating characteristic (ROC) curve were applied to verify the model’s goodness of fit and predictive performance. Results Univariate analysis showed that age, diabetes mellitus, systolic blood pressure, diastolic blood pressure, fasting blood glucose, glycosylated hemoglobin, total cholesterol, triglyceride, low-density lipoprotein cholesterol (LDL-C), platelet count (PLT), prothrombin time (PT), albumin (Alb), C-reactive protein (CRP), neutrophil-to-lymphocyte ratio (NLR), puncture conditions, skin dilation method were associated with blood oozing (all P<0.05). Multivariate logistic regression analysis confirmed that age ≥ 80 years, PLT≤25×10⁹/L, Alb≤35 g/L, CRP≥10 mg/L, repeated catheterization punctures, systolic blood pressure≥138 mmHg, glycated hemoglobin≥6.0%, and LDL-C≥3.0 mmol/L were independent risk factors for blood oozing. ROC curve analysis showed that the area under the curve (AUC) of the model for predicting puncture site oozing was 0.861; The Hosmer-Lemeshow goodness-of-fit test yielded aχ² value of 7.136, with P=0.522, indicating excellent goodness of fit and satisfactory predictive performance of the model. Conclusions Comprehensive assessment of high-risk factors related to advanced age, PLT, nutrition, inflammation, and vascular metabolism before catheterization, standardized puncture procedures, improvement of the success rate of one-time puncture, and implementation of individualized puncture site compression nursing can reduce the occurrence of blood oozing.

Key words: aged, hematological disease, peripherally inserted central catheters, puncture site oozing, risk factor