Construction of A Prediction Model for Acute Adverse Reactions Associated with Nonionic Iodine-contrast Agents in Patients with Cardio-cerebrovascular Disease
Objective To explore the value of building a prediction model for nonionic iodine-contrast associated acute adverse reactions(ICM-AARs)in patients with cardio-cerebrovascular disease.Methods 2031 patients with cardio-cerebrovascular disease who underwent CT enhanced examination in West China Hospital of Sichuan University from January 2020 to May 2023 were selected,and the incidence of AARs within 1h after ICM injection was analyzed.From the 2031 patients,174 patients without AARs who met the inclusion criteria were selected to be included in the non-ICM-AARS group,and 58 patients with AARs were included in the ICM-AARs group.The clinical data of the two groups were collected and compared.Logistic regression analysis was used to identify the risk factors leading to AARs in patients with cardio-cerebrovascular disease during enhanced CT examination.The nomogram prediction model was constructed using independent risk factors.Receiver operating characteristic curve(ROC),Bootstrap test and Calibration curve were used to evaluate the model.Results ICM-AARs occurred in 58 cases of 2031 patients with cardio-cerebrovascular disease.The incidence of ICM-AARs was 2.86％.The proportion of patients in ICM-AARs group with history of allergy,no hydration before examination,no external preheating,injection rate≥3.5 mL/s,the proportion of patients in ICM-AARs group with intravenous injection and using ioprosamide were higher than those in ICM-AARS group without ICM-AARS(P＜0.05).Logistic regression analysis showed that history of allergy,no hydration before examination,no external preheating,injection rate≥3.5 mL/s,intravenous injection and using ioprosamide were independent risk factors for ICM-AARs in enhanced CT examination(P＜0.05).ROC curve showed that the area under the curve(AUC)of the prediction model was 0.765(95％CI:0.706～818),the sensitivity was 89.66％,the specificity was 81.03％,and the Yoden index was 0.706.The verification result of Bootstrap method showed that C-index value was 0.779(95％CI:0.713～0.861).Calibration curve showed that Hosmer-Lemeshow x2=0.708,P=0.295.Conclusion Allergic history,no hydration before examination,no external preheating,injection rate≥3.5mL/s,intravenous injection and iopropramine are independent risk factors for ICM-AARs in patients with cardio-cerebrovascular disease.The nomogram prediction model constructed by the above factors has higher prediction efficiency for ICM-AARs.
万方数据
维普
