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建立一个模型预测非癌症相关咯血支气管动脉栓塞后复发。

Development of a model to predict recurrence after bronchial artery embolization for non-cancer related hemoptysis.

机构信息

Department of Interventional Radiology, The First Affiliated Hospital With Nanjing Medical University, No. 300 Guangzhou Road, Nanjing, 210029, China.

Department of Interventional Radiology, Jiangyin People's Hospital, Wuxi, 214400, China.

出版信息

BMC Pulm Med. 2021 Dec 18;21(1):419. doi: 10.1186/s12890-021-01790-2.

Abstract

BACKGROUND

Relapse after effective bronchial arterial embolization (BAE) for controlling hemoptysis is not uncommon. Studies reported diverse predictors of recurrence. However, a model to assess the probability of recurrence in non-cancer related hemoptysis patients after BAE has not been reported. This study was to develop a model to predict recurrence after BAE for non-cancer related hemoptysis.

METHODS

The study cohort included 487 patients who underwent BAE for non-cancer-related hemoptysis between January 2015 and December 2019. We derived the model's variables from univariate and multivariate Cox regression analyses. The model presented as a nomogram scaled by the proportional regression coefficient of each predictor. Model performance was assessed with respect to discrimination and calibration.

RESULTS

One-month and 1-, 2-, 3- and 5-year recurrence-free rates were 94.5%, 88.0%, 81.4%, 76.2% and 73.8%, respectively. Risk factors for recurrence were underlying lung diseases and the presence of systemic arterial-pulmonary circulation shunts. This risk prediction model with two risk factors provided good discrimination (area under curve, 0.69; 95% confidence interval, 0.62-0.76), and lower prediction error (integrated Brier score, 0.143).

CONCLUSION

The proposed model based on routinely available clinical and imaging features demonstrates good performance for predicting recurrence of non-cancer-related hemoptysis after BAE. The model may assist clinicians in identifying higher-risk patients to improve the long-term efficacy of BAE.

摘要

背景

支气管动脉栓塞术(BAE)有效控制咯血后复发并不少见。研究报道了多种复发的预测因素。然而,尚无报道评估非癌症相关咯血患者 BAE 后复发概率的模型。本研究旨在建立一个预测非癌症相关咯血患者 BAE 后复发的模型。

方法

本研究队列纳入了 2015 年 1 月至 2019 年 12 月期间因非癌症相关咯血接受 BAE 的 487 例患者。我们从单变量和多变量 Cox 回归分析中推导出模型变量。该模型以每个预测因子的比例回归系数为刻度表示为列线图。通过比较区分度和校准度评估模型性能。

结果

1 个月、1 年、2 年、3 年和 5 年无复发生存率分别为 94.5%、88.0%、81.4%、76.2%和 73.8%。复发的危险因素是基础肺部疾病和体循环-肺循环分流的存在。这个包含两个危险因素的风险预测模型具有良好的区分度(曲线下面积,0.69;95%置信区间,0.62-0.76),且预测误差较低(综合 Brier 评分,0.143)。

结论

基于常规临床和影像学特征的该预测模型对预测 BAE 治疗非癌症相关咯血后复发具有良好的性能。该模型可能有助于临床医生识别高风险患者,以提高 BAE 的长期疗效。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e40d/8684203/168662c3f6de/12890_2021_1790_Fig1_HTML.jpg

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