TACE术后恶心呕吐风险预测模型:一项横断面研究。

IF 2.5 3区 医学 Q2 GASTROENTEROLOGY & HEPATOLOGY
Yali Dai, Mengting Zeng, Hong He, Miao Cai
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引用次数: 0

摘要

目的:根据既往文献,发现肝癌经导管动脉化疗栓塞(Transcatheter Arterial Chemoembolization, TACE)后33.8% -52.5%的患者出现恶心和呕吐。但是没有模型可以预测这种风险。在这项研究中,我们调查了与TACE术后恶心和呕吐相关的因素,并建立了一个预测模型来预测这些不良事件。方法:401例患者按7:3的比例随机分为训练组和验证组。采用logistic回归分析识别预测因子,建立风险预测模型。使用曲线下面积(AUC)、校准曲线和决策曲线分析(DCA)评估模型性能。结果:本研究最终纳入401例TACE患者,其中132例(32.92%)患者出现恶心和呕吐。多变量分析确定了5个独立的风险预测因素:呕吐史、预防性使用止吐药、术后疼痛、铂和蒽环类药物。训练组的AUC为0.839,验证组的AUC为0.742。校正曲线分别为P = 0.208和P = 0.482。DCA曲线显示该模型在阈值概率大于20%时具有良好的临床效益。结论:建立了基于个体危险因素、手术因素和化疗药物因素的TACE术后恶心呕吐预测模型,具有满意的预测能力。该模型可以识别出有恶心和呕吐高风险的TACE患者。本研究为TACE高危恶心呕吐患者的早期发现、早期诊断和早期干预提供了经验依据。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
A risk prediction model for nausea and vomiting after TACE: a cross-sectional study.

Purpose: It was found that 33.8-52.5% of patients experienced nausea and vomiting after Transcatheter Arterial Chemoembolization (TACE) for liver cancer, based on prior literature. But there are no models that predict this risk. In this study, we investigated the factors associated with nausea and vomiting after TACE and developed a predictive model to predict these adverse events.

Method: The study will include 401 patients who will be randomly assigned to the training group and validation group in a 7:3 ratio. An analysis of logistic regression was used to identify predictors and build a risk prediction model. Model performance was evaluated using the Area Under Curve (AUC), Calibration Curve, and Decision Curve Analysis (DCA).

Results: This study ultimately included 401 patients for TACE, of whom 132(32.92%) patients experienced nausea and vomiting. Multivariate analysis identified five independent risk predictors: history of vomiting, prophylactic use of antiemetics, postoperative pain, platinum, and anthracycline. The training group had an AUC of 0.839, and the validation group had an AUC of 0.742. They had calibration curves with P = 0.208 and P = 0.482, respectively. The DCA curves showed that the model had good clinical benefit at threshold probabilities greater than 20%.

Conclusion: A predictive model of nausea and vomiting after TACE has been developed, based on the individual risk factors, surgical factors and chemotherapy drug factors, with satisfactory predictive ability. This model can identify patients for TACE who are at high risk of nausea and vomiting. Our study provides an empirical basis for early detection, early diagnosis and early intervention of patients for TACE at high risk of nausea and vomiting.

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来源期刊
BMC Gastroenterology
BMC Gastroenterology 医学-胃肠肝病学
CiteScore
4.20
自引率
0.00%
发文量
465
审稿时长
6 months
期刊介绍: BMC Gastroenterology is an open access, peer-reviewed journal that considers articles on all aspects of the prevention, diagnosis and management of gastrointestinal and hepatobiliary disorders, as well as related molecular genetics, pathophysiology, and epidemiology.
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