Objective To develop and validate a predictive model for the risk of contrast kidney injury after PCI.Methods 634 patient cases who underwent PCI in our hospital from January 2022 to November 2023 were selected for the study.They were divided in-to 443 cases in the model group and 191 cases in the validation group in a 7∶3 ratio.Parameters that may affect contrast renal injury after PCI were collected in the electronic medical record system,and patients were divided into 2 groups based on the positive outcome of contrast renal injury occurring within 72 h after surgery.The basic conditions,diseases,surgery-related indexes,and types of medica-tions used during hospitalization were compared between the 2 groups,and multifactorial Logisitic regression was performed after screening the variables with LASOO regression,so as to establish a nomogram model and validate the model.Results A total of 62(14.0％)of 443 patients in the model group of this study developed contrast renal injury.The results of multifactorial Logisitic regres-sion analysis performed on the basis of LASSO regression showed that emergency PCI,number of stents,amount of contrast used,type of contrast,type of hydration,and diuretics were the independent influencing factors of contrast renal injury after PCI(P＜0.05).The pre-dictive model was constructed with the independence influences obtained from multifactor Logistic regression and presented in the form of Nomogram.The results of model validation showed the following:differentiation:the area under the ROC curve in the model group was 0.728,with a 95％CI of(0.661～0.795);the area under the ROC curve in the validation group was 0.719,with a 95％CI of(0.652～0.786).Accuracy:the slopes of the calibration curves of the model and validation groups were 1,the intercept was 0.000,the model curves were basically fitted to the ideal model as a diagonal,and the H-L goodness-of-fit test was performed(P＞0.05).The results of clinical validity analysis showed the highest net benefit of using the model of this study to predict post-PCI contrast renal injury when the predictive probability threshold was 0.15 to 0.75.Conclusion Post-PCI contrast renal injury is influenced by factors such as e-mergency PCI,number of stents,and amount of contrast used,and the model developed in this study can be used to predict post-PCI contrast renal injury.
关键词
经皮冠状动脉介入/对比剂肾损伤/多因素分析/列线图模型
Key words
PCI/Contrast renal injury/Multifactorial analysis/Nomogram model
维普
万方数据