Construction and validation of a risk prediction model for intrapulmonary hemorrhage following preoperative mi-crocoil localization in thoracoscopic resection of pulmonary nodules
HAO Zheng-rong
WANG Kang-wu
ZHANG Zi-xuan
TAO Lei
Abstract：Objective To investigate the risk factors for intrapulmonary hemorrhage following preoperative micro-coil localization in patients undergoing thoracoscopic resection of pulmonary nodules,and to construct and validate a risk prediction model.Methods A total of 105 patients undergoing thoracoscopic resection of pulmonary nodules from March 2022 to September 2023 were enrolled.Based on the occurrence of intrapulmonary hemorrhage,patients were divided into a bleeding group and a non-bleeding group.Relevant preoperative and postoperative data were collected,and risk factor analysis was performed using univariate and multivariate logistic regression.A nomogram was constructed based on the i-dentified independent risk factors.Additionally,45 patients treated from September 2023 to June 2024 were prospectively collected as a validation cohort.Results Among the 105 patients,24(22.86％)experienced intrapulmonary hemor-rhage while 81(77.14％)did not.Multivariate logistic regression identified the following independent risk factors for post-localization intrapulmonary hemorrhage:distance from the nodule to the pleura(OR=1.297,95％CI:1.104-1.523,P=0.002),nodule size(OR=0.791,95％CI:0.645-0.969,P=0.024),number of punctures(OR=16.632,95％CI:1.425-194.153,P=0.025),and concomitant hypertension(OR=4.293,95％CI:1.188-15.516,P=0.026).Based on these factors,the nomogram risk model was constructed with the following equation:Logit(p)=0.260 ×(distance from the nodule to the pleura)-0.235 ×(nodule size)+2.811 ×(number of punctures)+1.457 ×(presence of hypertension)-2.697.The model demonstrated excellent predictive performance with an area under the receiver operating characteristic(ROC)curve of 0.865(95％CI:0.780-0.950),a sensitivity of 83.3％,a speci-ficity of 79.0％,and a Youden index of 0.623.The Hosmer-Lemeshow test yielded x2=6.761(P=0.563),indica-ting a good model fit.Conclusion The risk prediction model based on our logistic regression analysis can effectively i-dentify risk factors associated with early intrapulmonary hemorrhage after microcoil localization.This model may assist cli-nicians in implementing timely preventive measures to reduce the occurrence of postoperative intrapulmonary hemorrhage.
Keywords：microcoil localizationintrapulmonary hemorrhagepulmonary nodulethoracoscopic resectionrisk predictionnomogram
Publication Date：2025-05-15
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：6( 719-724 )