Construction of a risk prediction model for arteriovenous fistula loss in maintenance hemodialysis patients
Objective:To explore the risk factors for arteriovenous fistula(AVF)failure in patients undergoing maintenance hemodialysis(MHD),construct a risk nomogram model,and validate its performance.Methods:A total of 133 MHD patients admitted to our hospital from June 2022 to June 2023 were selected as study subjects.The risk factors for AVF failure in MHD patients were analyzed,and a corresponding nomogram was developed.The predictive performance of the model was assessed using the Receiver Operating Characteristic(ROC)curve,calibration curve,and goodness-of-fit test.The clinical applicability of the model was evaluated using the clinical decision curve.Results:Among the 133 MHD patients,30(22.6% )experienced AVF failure.Logistic regression analysis revealed that advanced age(≥60 years),aortic arch calcification,inexperienced puncture technique,hypotension,smoking history,and thrombosis were independent risk factors for AVF failure.The area under the ROC curve(AUC)of the constructed risk prediction model was 0.908,with a sensitivity of 93.30% and a specificity of 69.90% .The calibration curve results showed good agreement between the model's predicted probabilities and actual occurrences.The clinical decision curve results indicated that the model had high clinical applicability.Conclusion:AVF failure in MHD patients is influenced by multiple factors,and the predictive model based on these risk factors has high clinical application value.
hemodialysisarteriovenous fistula lossinfluencing factorsprediction modelinvestigation and research
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