Development and evaluation of a nutritional risk prediction model for patients with hepatocellular carcinoma undergoing transarterial chemoembolisation

开发和评估接受经动脉化疗栓塞术的肝细胞癌患者的营养风险预测模型

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Abstract

To study the risk factors for malnutrition in patients with hepatocellular carcinoma undergoing transarterial chemoembolisation (TACE), construct a risk prediction model and evaluate its predictive effectiveness. A retrospective study was conducted, selecting 194 cases of patients with liver cancer who received their first TACE treatment in the interventional department of a tertiary first-class hospital in Nantong, Jiangsu Province, between January 2019 and December 2023. General data and factors related to malnutrition were retrospectively collected, and the occurrence of malnutrition within 3 months following TACE surgery was observed. Univariate analysis and multivariate logistic regression analysis were performed on the data, a predictive model was constructed and the model performance was evaluated using the Hosmer-Lemeshow (HL) test and receiver operating characteristic (ROC) curve analysis. The incidence of malnutrition was 36.08%. Multivariate logistic regression analysis showed that haemoglobin (Hb) (P = 0.048, odds ratio [OR] = 0.971), age (P = 0.017, OR = 1.068), Child-Pugh (CP) class score (P = 0.000, OR = 11.780), L3-psoas muscle index (L3-PMI) (P = 0.036, OR = 0.062) and albumin (ALB) (P = 0.000, OR = 0.804) were independent risk factors for malnutrition. The area under the ROC curve of the constructed model was 0.958, indicating its strong predictive power. The HL goodness-of-fit test (P > 0.05) suggested that the model fit was good. Advanced age, high CP grade, low L3-PMI, low ALB and low Hb are independent risk factors for malnutrition in patients undergoing TACE for liver cancer. The constructed model can provide a scientific basis for nutritional management of patients.

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