1.Establishment and Validation of Nomogram Prediction Model in Patients with Cirrhosis and Portal Vein Thrombosis
Menghuan ZHU ; Duohua LI ; Kejian WU
Journal of Medical Research 2024;53(7):156-162
Objective To establish and verify nomogram prediction model with portal vein thrombosis in patients with cirrhosis,so as to evaluate its clinical application value.Methods The clinical data of 464 patients with cirrhosis with or without PVT admitted by our hospital from January 2015 to October 2022 were collected,univariate and multivariate Logistic regression analysis were used to screen the independent risk factors for PVT in patients with liver cirrhosis,and a nomogram prediction model was established,and the nomogram pre-diction model was verified for discrimination,calibration and clinical validity.Results Univariate and multivariate Logistic regression a-nalysis showed that the history of splenectomy,portal vein diameter,D-dimer and C-reactive protein-to-albumin ratio(CAR)were independent risk factors for cirrhosis with portal vein thrombosis(P<0.05),the above independent risk factors were incorporated and a nomogram prediction model was successfully established.The nomogram was verified in both the modeling and validation populations:the area under the receiver operating characteristic(ROC)curve were 0.846(95%CI:0.803-0.888)and 0.815(95%CI:0.743-0.887),respectively,and the prediction model had good discrimination.The P-values in Hosmer-Lemeshow test were 0.783 and 0.453,respectively,and the model fitted well.The calibration chart showed that the nomogram model showed good calibration for the pre-diction probability of liver cirrhosis with PVT.Decision curve analysis(DCA)showed that the nomogram had good application value.Conclusion By establishing and validating a simple and practical nomogram prediction model for the risk of PVT in patients with cirrho-sis,it can help clinicians identify and intervene high-risk patients early.