Objective To construct a nomogram model for postoperative arteriovenous fistula(AVF)dys-function in hemodialysis patients.Methods A total of 126 hemodialysis patients undergoing AVF operation in our hospital from July 2021 and July 2023 were taken as the research subjects.They were divided into dys-function group(n=31)and normal function group(n=95)according to the postoperative AVF function.Their clinical data were collected.The influencing factors for postoperative AVF dysfunction in hemodialysis pa-tients were investigated by logistic stepwise regression analysis.A nomogram model of risk prediction for postoperative AVF dysfunction in hemodialysis patients was constructed,and its predictive value was evaluat-ed using receiver operating characteristic(ROC)curve.Results The incidence of AVF dysfunction in the 216 hemodialysis patients was 24.60％(31/126).The ratios of ≥ 60 years old,diabetes mellitus and hypotension during dialysis,and the values of platelet count,LDL-C,blood phosphorus,and calcium and phosphorus product were higher in dysfunction group than in normal function group(t/x2=4.946,4.527,10.333,9.789,7.164,16.065,and 18.817 respectively,P=0.026,0.033,＜0.001,＜0.001,＜0.001,＜0.001 and＜0.001 respec-tively),while serum albumin was lower in dysfunction group than in normal function group(t=7.997,P＜0.001).Multivariate logistic regression showed that age≥60 years old(OR=2.061,95％CI:1.431～2.967,P＜0.001),combined with diabetes mellitus(OR=2.776,95％CI:1.814～4.247,P＜0.001),hypotension during dialysis(OR=2.286,95％CI:1.542～3.390,P＜0.001),higher platelet count(OR=2.499,95％CI:1.643～3.802,P＜0.001)and higher calcium and phosphorus product(OR=2.234,95％CI:1.528～3.268,P＜0.001)were the independent risk factors for postoperative AVF dysfunction in hemodialysis patients.The C-index was 0.738(95％CI:0.687～0.789)for predicting postoperative AVF dysfunction in hemodialysis patients.ROC curve for the nomogram to predict postoperative AVF dysfunction in hemodialysis patients showed that the area under the curve(AUC)was 0.792[95％CI:0.792(0.741～0.843)],with the specificity of 73.05％and the sensitivity of 78.14％(Z=11.257,P＜0.001).Hosmer-Lemeshow goodness of fit test was 8.746(P=0.394).Conclusion The nomogram based on age,combined diabetes,hypotension,platelet count,calcium and phosphorus product had a higher predictive value for the risk of postoperative AVF dysfunction in hemodi-alysis patients.
HemodialysisArteriovenous fistula dysfunctionRisk factorNomogram model
万方数据
维普
