ObjectiveTo explore the risk factors affecting on catheter obstruction during hyperthermic intraperitoneal chemotherapy (HIPEC). MethodsBased on the inclusion and exclusion criteria, the data of the patients who underwent HIPEC and related perfusion records at the First Affiliated Hospital of Xi’an Jiaotong University from February 2023 to December 2023 were retrospectively collected. The collected data were analyzed using Chi-square tests, machine learning, and non-parametric tests. The significance level was set at α=0.05. ResultsA total of 210 HIPEC patients meeting the criteria were included, of whom 51 (24.3%) experienced catheter obstruction. The univariate analysis revealed that the inflow-outflow temperature gradient of the perfusate (ΔT of the perfusate), perfusion flow rate, chemotherapy exposure, hypertension status, surgical approach, and HIPEC catheter length were associated with catheter obstruction (P<0.05). Subsequently, combining the results of the univariate analysis with feature values screened by machine learning, the following factors were selected, including HIPEC catheter length, ΔT of the perfusate, perfusion flow rate, age, gender, chemotherapy exposure, fibrinogen level, hypertension status, surgical approach, and blood transfusion. A predictive model for HIPEC catheter obstruction based on these features was established, achieving an area under the receiver operating characteristic curve (AUC) (95%CI) of 0.825 (0.757, 0.893). ConclusionThis study preliminarily identifies key factors influencing the incidence of catheter obstruction during HIPEC treatment, such as ΔT of the perfusate, perfusion flow rate, chemotherapy exposure, surgical approach, HIPEC catheter length, and hypertension, continuously monitoring these factors, thereby reducing the risk of catheter obstruction.