首页|腔静脉滤器困难性回收Nomogram个体化预测模型

腔静脉滤器困难性回收Nomogram个体化预测模型

扫码查看
原文链接
  • NETL
  • NSTL
  • 万方数据
腔静脉滤器是为预防深静脉血栓脱落导致致命性肺栓塞而设计的装置，在滤器回收过程中常出现不同程度的技术困难，需借助辅助器械和静脉通路。建立有效的预测模型提前预测滤器回收困难程度有助于术前规划、沟通和术中高效配合。本文回顾性分析2011年1月至2020年12月在中南大学湘雅三医院进行的477例腔静脉滤器回收病例，其中顺利回收344例，困难性回收137例(包括35例回收失败)。运用单因素与多因素logistic回归分析筛选困难性回收的相关风险因素，再构建Nomogram预测模型并用ROC曲线验证模型的准确性，其中2011年1月至2017年12月病例资料为训练队列，2018年1月至2020年12月资料为验证队列。单因素分析结果显示滤器是否贴壁、滤器是否穿透腔静脉、滤器与血管长轴之间夹角、实际使用时间与建议置入时间比值、是否规律抗凝是腔静脉滤器困难性回收的风险因素，在此基础上进一步使用logistic多因素回归分析显示，滤器是否贴壁、滤器是否穿透腔静脉、是否规律抗凝是预测腔静脉滤器困难性回收的独立风险因素。将上述三种风险进一步构建Nomogram预测模型，内部验证评价AUC值为0。819，外部验证评价AUC值为0。817;内部验证和外部验证的校准曲线均提示模型能有效预测困难性回收风险。构建腔静脉滤器困难性回收Nomogram图预测模型的纳入变量在术前易于获得，模型具有较好的预测效果和较低的泛化误差，可为血管介入医生在腔静脉滤器回收治疗决策提供重要依据。
Nomogram for individualized prediction of inferior vena cava filter retrieval difficulty
Inferior vena cava filter(IVCF)could reduce the risk of fatal pulmonary embolism.However,procedural difficulties often exist during IVCF retrieval,requiring extra devices and venous access.Thus,an effective prediction model is essential to predicting the difficulties in preoperative planning,hence aiding efficient intraoperative cooperation.This study retrospectively analyzed 477 cases of IVCF retrievals in the center of the Third Xiangya Hospital of Central South University from 2011 to 2020,among which 344 cases were defined non-difficult retrieval and 133 cases as difficult retrieval(including 35 failed retrievals).The cases before 2017 were classified as training cohort(TC),while the rest as validation cohort(VC).A nomogram was generated to predict IVCF retrieval difficulty with risk factors validated by univariate and multivariate logistic regression analysis.The study then evaluated the model performance with calibration plot,receiver operating characteristic curve(ROC)and decision curve analysis(DCA).It is shown that IVCF retrieval difficulty increases significantly when factors of embedded top of the filter,leg penetration,and irregular anticoagulation occur.Moreover,the nomogram shows the predictive accuracy values of TC and VC are 0.819 and 0.817,respectively.The calibration curve of TC and VC indicates that the model can effectively predict the risk of difficult retrieval.This nomogram has good predictive effect and low generalization error,which can provide evidence for surgical decision of IVCF retrieval.

nomograminferior vena cava filter retrievalunivariate and multivariate logistic regression analysisdecision curve analysishospital information system

于姗姗、谢佳怡、薛碧晨、徐宏博

展开 >

The Third Xiangya Hospital,Central South University,Changsha 410013,China

诺模图 下腔静脉滤器回收 单变量和多变量逻辑回归分析 校准曲线分析 医院信息系统

Hunan Health Commission,China

B202304138795

2024

10.1007/s11771-024-5667-7

中南大学学报(英文版)
中南大学

中南大学学报(英文版)

CSTPCDEI
影响因子：0.47
ISSN：2095-2899
年,卷(期)：2024.31(5)
  • 23