{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,18]],"date-time":"2026-09-18T07:20:43Z","timestamp":1789716043679,"version":"4.0.1"},"reference-count":35,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,2,12]],"date-time":"2026-02-12T00:00:00Z","timestamp":1770854400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Pediatr."],"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To develop and validate a risk prediction model for unplanned removal (UR) of peripherally inserted central catheters (PICC) in preterm infants with gestational age (GA)\u2009&amp;lt;\u200932 Weeks.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This retrospective study analyzed preterm infants with PICC admitted to a neonatal intensive care unit (NICU) (January 2018 to December 2024). Clinical and catheter-related variables were assessed. Multivariable logistic regression identified predictors of PICC-UR, with model performance evaluated by C-index, calibration, and decision curve analysis (internal validation via 1000 bootstraps).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>We identified five independent predictors for PICC-UR: insertion site (categorical), white blood cell count (WBC), platelet count (PLT), and fibrinogen (Fib) (all modeled as continuous linear terms), along with hypercholanemia (HCA). These predictors were integrated into a nomogram designed to estimate the individual risk of PICC-UR in preterm infants. The predictive model demonstrated a high accuracy with a C-index of 0.827 [95% confidence interval (CI): 0.740\u20130.915]. Internal validation confirmed excellent calibration and significant clinical utility based on decision curve analysis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>This validated nomogram, incorporating insertion site, WBC, PLT, Fib and HCA, aids early identification of high-risk infants. It offers actionable insights for optimizing PICC fixation and biochemical monitoring, potentially reducing PICC-UR in NICU.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fped.2026.1725396","type":"journal-article","created":{"date-parts":[[2026,2,12]],"date-time":"2026-02-12T07:20:27Z","timestamp":1770880827000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":1,"title":["Development and validation of a nomogram for predicting unplanned PICC removal in preterm infants with gestational age &lt;32 weeks"],"prefix":"10.3389","volume":"14","author":[{"given":"Yuedi","family":"Hu","sequence":"first","affiliation":[{"name":"Department of Pediatrics, Third Military Medical University Southwest Hospital","place":["Chongqing, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yu","family":"Lang","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Third Military Medical University 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