Ning Zhou, Nan Feng, Zichen Jiao, Xiaoming Shi, Tao Wang, Gefei Zhao
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Binary logistic regression was performed to further analyze these factors. Receiver Operating Characteristic (ROC) curves were plotted to assess model performance, and Bootstrap validation evaluated discriminative ability. Calibration curves and decision curve analysis (DCA) were conducted to compare predicted versus actual probabilities and assess clinical applicability.</p><p><strong>Results: </strong>The incidence of PR was 5.35% (25/467). Significant variables from univariate analysis and LASSO regression were analyzed by logistic regression. Age, intrapulmonary needle path adjustment, inadequate anesthesia, and a history of diabetes were identified as independent risk factors for PR. ROC curves showed Area Under the Curve (AUC) values indicating excellent discriminative ability. Calibration curves showed appropriate fit, and DCA demonstrated high clinical applicability.</p><p><strong>Conclusion: </strong>Younger age groups, intraprocedural needle adjustments, inadequate anesthesia, and diabetes were independent risk factors for PR after CT-PLNL. Optimizing anesthesia, avoiding unnecessary needle manipulations, and perioperative glucose monitoring in diabetic patients may mitigate PR risks and enhance procedural safety.</p>","PeriodicalId":22977,"journal":{"name":"Therapeutics and Clinical Risk Management","volume":"21 ","pages":"1161-1173"},"PeriodicalIF":2.8000,"publicationDate":"2025-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12301428/pdf/","citationCount":"0","resultStr":"{\"title\":\"Risk Factors for Pleural Reaction in CT-Guided Percutaneous Lung Nodule Localization: A Single-Center Retrospective Study.\",\"authors\":\"Ning Zhou, Nan Feng, Zichen Jiao, Xiaoming Shi, Tao Wang, Gefei Zhao\",\"doi\":\"10.2147/TCRM.S516329\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>Pleural reaction (PR) frequently occurs during computed tomography (CT) -guided lung puncture procedures, and its development is influenced by various factors. 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引用次数: 0
摘要
背景：胸膜反应（PR）在计算机断层扫描（CT）引导下的肺穿刺过程中经常发生，其发展受多种因素的影响。本研究旨在确定ct引导下经皮肺结节定位（CT-PLNL）手术中与PR相关的危险因素。方法：本回顾性研究纳入了2022年1月至2023年12月在南京鼓楼医院行胸外科视频辅助手术（VATS）的467例患者，所有患者均接受了CT-PLNL。收集临床资料，包括医疗记录、影像学发现和实验室结果。单因素分析和最小绝对收缩和选择算子（LASSO）回归确定了PR的独立危险因素。采用二元逻辑回归进一步分析这些因素。绘制受试者工作特征（ROC）曲线来评估模型的性能，Bootstrap验证评估模型的判别能力。校正曲线和决策曲线分析（DCA）比较预测概率和实际概率，评估临床适用性。结果：PR的发生率为5.35%（25/467）。单因素分析和LASSO回归的显著变量采用logistic回归分析。年龄、肺内针径调整、麻醉不充分、糖尿病史被确定为PR的独立危险因素。ROC曲线显示曲线下面积（Area Under the Curve， AUC）值，表明具有良好的判别能力。校正曲线拟合良好，DCA具有较高的临床适用性。结论：年龄较小、术中调针、麻醉不充分和糖尿病是CT-PLNL术后发生PR的独立危险因素。优化麻醉，避免不必要的针头操作，以及糖尿病患者围手术期血糖监测可降低PR风险，提高手术安全性。
Risk Factors for Pleural Reaction in CT-Guided Percutaneous Lung Nodule Localization: A Single-Center Retrospective Study.
Background: Pleural reaction (PR) frequently occurs during computed tomography (CT) -guided lung puncture procedures, and its development is influenced by various factors. This study aims to identify the risk factors associated with PR in CT-guided percutaneous lung nodule localization (CT-PLNL) procedures.
Methods: This retrospective study included 467 patients who underwent video-assisted thoracic surgery (VATS) at Nanjing Drum Tower Hospital between January 2022 and December 2023, all of whom had received CT-PLNL. Clinical data, including medical records, imaging findings, and laboratory results, were collected. Univariate analysis and Least Absolute Shrinkage and Selection Operator (LASSO) regression identified independent risk factors for PR. Binary logistic regression was performed to further analyze these factors. Receiver Operating Characteristic (ROC) curves were plotted to assess model performance, and Bootstrap validation evaluated discriminative ability. Calibration curves and decision curve analysis (DCA) were conducted to compare predicted versus actual probabilities and assess clinical applicability.
Results: The incidence of PR was 5.35% (25/467). Significant variables from univariate analysis and LASSO regression were analyzed by logistic regression. Age, intrapulmonary needle path adjustment, inadequate anesthesia, and a history of diabetes were identified as independent risk factors for PR. ROC curves showed Area Under the Curve (AUC) values indicating excellent discriminative ability. Calibration curves showed appropriate fit, and DCA demonstrated high clinical applicability.
Conclusion: Younger age groups, intraprocedural needle adjustments, inadequate anesthesia, and diabetes were independent risk factors for PR after CT-PLNL. Optimizing anesthesia, avoiding unnecessary needle manipulations, and perioperative glucose monitoring in diabetic patients may mitigate PR risks and enhance procedural safety.
期刊介绍：
Therapeutics and Clinical Risk Management is an international, peer-reviewed journal of clinical therapeutics and risk management, focusing on concise rapid reporting of clinical studies in all therapeutic areas, outcomes, safety, and programs for the effective, safe, and sustained use of medicines, therapeutic and surgical interventions in all clinical areas.
The journal welcomes submissions covering original research, clinical and epidemiological studies, reviews, guidelines, expert opinion and commentary. The journal will consider case reports but only if they make a valuable and original contribution to the literature.
As of 18th March 2019, Therapeutics and Clinical Risk Management will no longer consider meta-analyses for publication.
The journal does not accept study protocols, animal-based or cell line-based studies.
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