青岛大学学报（医学版）2023，Vol.59Issue(6)：835-839,5.DOI:10.11712/jms.2096-5532.2023.59.178
CAS颅内出血危险因素分析及风险预测模型构建
ANALYSIS OF RISK FACTORS FOR INTRACRANIAL HEMORRHAGE AFTER CAROTID ARTERY STENTING AND RISK PRE-DICTION MODEL CONSTRUCTION
摘要
Abstract
Objective To investigate the risk factors for intracranial hemorrhage(ICH)after carotid artery stenting(CAS),and construct and validate a nomogram prediction model based on the risk factors,and to provide individualized treatment strategies for patients with carotid artery stenosis.Methods We included 568 patients who underwent CAS for internal carotid artery stenosis at The Affiliated Hospital of Qingdao University from June 2017 to June 2022.They were divided into ICH group(20 cases)and non-ICH group(548 cases)according to whether ICH occurred after surgery.Logistic regression analysis was per-formed on preoperative,intraoperative,and postoperative data to determine independent risk factors for a nomogram prediction model.The Bootstrap method was used for internal validation.Results Female(OR=3.395,P<0.05),a history of ischemic stroke(OR=4.038,P<0.05),a history of hypertension(OR=4.740,P<0.05),and second-level collateral compensation(OR= 6.218,P<0.05)were independent risk factors for ICH after CAS.A nomogram prediction model was constructed based on the above four risk factors.The area under the receiver operating characteristic curve for the model predicting ICH after CAS was 0.819(95%CI=0.726-0.912).Using the Bootstrap method to perform resampling 1 000 times,the index of concordance was 0.819.The Hosmer-Lemeshow goodness-of-fit test and calibration curve analysis showed good consistency between actual and predicted probabilities.Conclusion Female,hypertension,past ischemic stroke,and second-level collateral compensation may increase the risk of ICH after CAS in patients with carotid artery stenosis.The nomogram model based on these risk factors has high cali-bration and discrimination in predicting ICH after CAS treatment,which can facilitate early identification of patients at high risk for ICH.关键词
颈动脉狭窄/支架/血管成形术/颅内出血/危险因素/列线图Key words
carotid stenosis/stents/angioplasty/intracranial hemorrhages/risk factors/nomograms分类
医药卫生引用本文复制引用
张铭宇,滕文慧,张贤军,倪杰,韩龙龙,王乃东..CAS颅内出血危险因素分析及风险预测模型构建[J].青岛大学学报（医学版）,2023,59(6):835-839,5.基金项目
国家自然科学基金资助项目(81901194) （81901194）
