Nomogram-based prediction of the prognosis in patients with free floating venous thrombus after closed traumatic fracture.

IF 2.9 3区医学 Q2 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING

BMC Medical Imaging Pub Date : 2025-05-05 DOI:10.1186/s12880-025-01695-0

Yao Wei, Changxu Guo, Xiaoyu Chen, Yu Yuan

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引用次数: 0

Abstract

Background: Free-floating venous thrombosis (FFVT), a distinct subtype of deep vein thrombosis (DVT), is associated with pulmonary thromboembolism (PTE) and carries a high mortality risk.

Objective: This study aimed to develop a nomogram to predict the prognosis of FFVT in patients with closed traumatic fractures.

Materials and methods: A retrospective analysis of clinical and ultrasound data from 326 patients with FFVT post-closed traumatic fractures was conducted. Patients were divided into training (n = 240, January 2019-June 2023) and validation (n = 86, June 2023-June 2024) sets. Prognostic risk factors were identified using LASSO and multivariable logistic regression. A nomogram was constructed using R Studio, and its predictive accuracy was validated via calibration curves, receiver operating characteristic (ROC) analysis, and external validation.

Results: Independent risk factors for FFVT progression to closed thrombus included D-dimer levels, FFVT location, collateral blood flow volume around the thrombus, and thrombus margins (P < 0.05). The model demonstrated high discriminative ability, with a C-index of 0.945. ROC analysis revealed areas under the curve (AUC) of 0.949 (training set) and 0.924 (validation set). Calibration curves confirmed strong agreement between predicted and observed outcomes.

Conclusion: The nomogram provides an accurate prognostic tool for FFVT in patients with closed traumatic fractures, aiding clinical decision-making to improve patient outcomes.

Clinical trial number: Not applicable.

查看原文本刊更多论文

外伤性闭合性骨折后自由漂浮静脉血栓的影像学预后预测。

背景：自由漂浮静脉血栓形成（FFVT）是深静脉血栓形成（DVT）的一种独特亚型，与肺血栓栓塞（PTE）相关，具有高死亡率风险。目的：本研究旨在建立一种预测闭合性创伤性骨折患者FFVT预后的图。材料与方法：回顾性分析326例外伤性闭合性骨折后FFVT患者的临床及超声资料。患者分为训练组（n = 240, 2019年1月- 2023年6月）和验证组（n = 86, 2023年6月- 2024年6月）。使用LASSO和多变量logistic回归确定预后危险因素。利用R Studio构建nomogram，并通过校准曲线、受试者工作特征（receiver operating characteristic， ROC）分析和外部验证验证其预测准确性。结果：FFVT发展为闭合性血栓的独立危险因素包括d -二聚体水平、FFVT位置、血栓周围侧支血流量和血栓边缘(P)结论：nomogram为闭合性创伤性骨折患者FFVT提供了准确的预后工具，有助于临床决策以改善患者预后。临床试验号：不适用。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

BMC Medical Imaging RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING-

CiteScore

4.60

自引率

3.70%

发文量

198

审稿时长

27 weeks

期刊介绍： BMC Medical Imaging is an open access journal publishing original peer-reviewed research articles in the development, evaluation, and use of imaging techniques and image processing tools to diagnose and manage disease.