Analysis of risk factors for acute liver function deterioration after liver cancer intervention surgery and construction and validation of a risk column chart model
Objective:Investigating the risk factors for acute liver function deterioration(ALFD)following transcatheter arterial chemoembolization(TACE)for hepatocellular carcinoma,developing a nomogram model to predict the occurrence of postoperative ALFD,and validating its accuracy.Methods:A retrospective analysis was conducted on the data of 163 liver cancer patients who underwent interventional surgery in our hospital from January 2020 to December 2022.They were separated into ALFD group and good group based on whether ALFD occurred after surgery.General information,disease and interventional procedure data,and preoperative laboratory examination data were collected for univariate analysis,and multivariate analysis was applied to analyze the risk factors for postoperative ALFD after TACE.Based on this,a prediction model for postoperative ALFD in TACE was constructed,and its effectiveness was verified using the area under the ROC curve(AUC)and calibration curve.Results:Among 163 patients,44 cases developed ALFD after interventional surgery,with an incidence rate of 26.99%.There were differences between the two groups in preoperative Child-Pugh grading,concurrent portal vein cancer thrombus,number of interventional treatments,preoperative Alb,preoperative NLR,and preoperative APRI(P<0.05).Logistic regression analysis showed that the main risk factors for the occurrence of ALFD included Child-Pugh grade B,concurrent portal vein tumor thrombus,interventional therapy frequency>2 times,preoperative NLR≥3.81,and high preoperative APRI;internal validation shows that the AUC was 0.837(95%CI:0.773-0.902),and the probability of ALFD predicted by the model was highly consistent with the actual probability,the goodness of fit HL test showed χ2=11.305,and P=0.185.Conclusion:A column chart model constructed based on preoperative Child-Pugh grading,presence or absence of portal vein tumor thrombus,number of interventional treatments,preoperative NLR,and preoperative APRI can effectively predict postoperative ALFD in liver cancer.
liver cancerinterventional surgeryacute liver function deteriorationrisk factorscolumn chart model
万方数据
维普
