Dai Yali, Zeng Mengting, He Hong, Cai Miao
The 2 nd Affiliated Hospital, Jiangxi Medical College, Nanchang University, JiangXi, 330006, China.
School of Nursing, Jiangxi Medical College, Nanchang University, JiangXi, 330006, China.
BMC Gastroenterol. 2025 Jun 4;25(1):427. doi: 10.1186/s12876-025-03934-8.
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.
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).
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%.
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.
根据既往文献,经动脉化疗栓塞术(TACE)治疗肝癌后,33.8% - 52.5%的患者会出现恶心和呕吐。但尚无预测该风险的模型。在本研究中,我们调查了TACE术后恶心和呕吐的相关因素,并开发了一个预测模型来预测这些不良事件。
该研究将纳入401例患者,这些患者将按7:3的比例随机分配至训练组和验证组。采用逻辑回归分析来识别预测因素并建立风险预测模型。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。
本研究最终纳入401例行TACE的患者,其中132例(32.92%)患者出现恶心和呕吐。多因素分析确定了五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、铂类和蒽环类药物。训练组的AUC为0.839,验证组的AUC为0.742。它们的校准曲线P值分别为0.208和0.482。DCA曲线显示,在阈值概率大于20%时,该模型具有良好的临床效益。
基于个体风险因素、手术因素和化疗药物因素,开发了TACE术后恶心和呕吐的预测模型,预测能力令人满意。该模型可识别TACE术后发生恶心和呕吐高风险的患者。我们的研究为恶心和呕吐高风险的TACE患者的早期发现、早期诊断和早期干预提供了实证依据。