Predicting the risk of postoperative hemorrhage in percutaneous renal biopsy based on LASSO regression and nomogram
[Objective]To explore the risk factors for postoperative bleeding after ultrasound-guided percutaneous renal biopsy and establish a nomogram model.[Methods]Clinical and imaging data of inpatients who underwent real-time ultrasound-guided percutaneous renal puncture biopsy were retrospectively collected in the Department of Ultrasound Medicine of Taihe Hospital,Shiyan City,between June 1,2022 and June 1,2023.LASSO regression and Logistic regression analysis were used to establish a nomogram model for postoperative bleeding after ultrasound-guided percutaneous renal biopsy.The model was evaluated at three levels:receiver operation characteristic(ROC)curve,calibration curve,and decision curve analysis(DCA).[Results]A total of 206 patients who underwent ultrasound-guided percutaneous renal biopsy were included in this study.LASSO regression and logistic regression analysis showed that a history of hypertension((∧OR)=5.339,P＜0.001),cortical thickness of the lower pole of the punctured kidney((∧OR)=0.410,P＜0.001),unclear boundary between the cortex and medulla of the punctured kidney((∧OR)=6.133,P＜0.001),and patient non-cooperation during puncture((∧OR)=4.525,P=0.004)were independent risk factors for postoperative bleeding after ultrasound-guided renal puncture biopsy.The nomogram model had good diagnostic performance with an AUC of 0.891 and 95％CI of 0.842-0.941.The calibration curve showed a mean absolute error of 0.026,indicating a good fit between the ideal curve and the calibration curve.The Hosmer-Lemeshow test x2=6.599,P=0.580(P＞0.05),indicating good accuracy of the model.The clinical decision curve showed that the model had the highest net benefit when the threshold probability of the nomogram model was less than 89％.[Conclusion]A history of hypertension,cortical thickness of the lower pole of the punctured kidney,unclear boundary between the cortex and medulla of the punctured kidney,and patient non-cooperation during puncture are risk factors for postoperative bleeding after ultrasound-guided percutaneous renal biopsy.The nomogram model can feasibly predict postoperative bleeding after ultrasound-guided renal puncture biopsy and provide visual evidence for the clinical assessment of bleeding risk.
percutaneous renal biopsy(PRB)haemorrhagiarisk factorleast absolute shrinkage and selection operator(LASSO)regressionnomogram
万方数据
维普
