Construction of a clinical blood transfusion prediction model for patients with dangerous placenta previa
Objective To construct a clinical blood transfusion prediction model for patients with dangerous placenta previa,to verify its prediction efficacy,and to guide the decision of clinical blood transfusion.Methods A retrospective analysis was performed on 200 patients with dangerous placenta previa who were hospitalized in Northwest Women's and Children's Hospital from January 2021 to December 2023,including 90 patients in the blood transfusion group,who were(33.55±3.95)years old and(34.45±2.12)weeks pregnant,and 110 patients in the non-transfusion group,who were(32.50±4.21)years old and(35.27±1.85)weeks pregnant.The clinical data and pregnancy outcomes were compared between the two groups.The logistic regression algorithm was used to screen out the independent risk factors related to blood transfusion.A nomogram prediction model was constructed by R language,and the performance of the model was evaluated.t,x2,and rank sum tests were applied.Results There were no statistical differences in age,body mass index,pregnant times,abortion history,hypertension,diabetes,thyroid function,and newborn's body weight between the two groups(all P＞0.05).The proportions of the patients with pregnant times ≥3,prenatal anemia,and placenta implantation,ultrasound score,postpartum bleeding volume,and hospital stay in the transfusion group were higher than those in the non-transfusion group[5.6％(5/90)vs.2.8％(3/110),60.0％(54/90)vs.30.0％(33/110),90.0％(81/90)vs.32.7％(36/110),9(8,11)vs.6(5,7),1 800(1 200,2 500)ml vs.600(500,800)ml,8(6,12)d vs.6(5,8.3)d];the gestational weeks in the transfusion group was lower than that in the non-transfusion group[(34.45±2.12)weeks vs.(35.27±1.85)weeks];there were statistical differences(x2=23.660,18.120,and 66.880;Z=8.080,10.590,and 3.730;t=-2.820;all P＜0.05).The multivariate logistic regression analysis showed that postpartum hemorrhage,prenatal anemia,placenta implantation,and placenta ultrasound score were independent risk factors for blood transfusion in the patients(all P＜0.05).A nomogram prediction model was constructed;the area under the curve was 0.96(95％CI 0.939-0.986),indicating that the model had good prediction performance.Conclusions Postpartum hemorrhage,prenatal anemia,placenta implantation,and placenta ultrasound score are independent risk factors leading to blood transfusion in patients with dangerous placenta previa.The constructed nomogram prediction model can predict the patients'blood transfusion needs,and has high clinical decision-making value.
Postpartum hemorrhageDangerous placenta previaPlacental implantationBlood transfusionPrediction model
万方数据
维普
