PDF(Pubmed)
Abstract：
UNASSIGNED: There are almost 2 million adult patients with congenital heart disease in China, and the number of moderate and severe patients is increasing. However, few studies have investigated the risk of serious adverse events (SAE) after catheterization among them. The aim of this study was to identify risk factors for SAE related to cardiac catheterization and to provide the risk scoring model for predicting SAE.
UNASSIGNED: A total of 690 patients with moderate and severe adult patients with congenital heart disease (ACHD) who underwent cardiac catheterization in Wuhan Asian Heart Hospital Affiliated to Wuhan University of Science and Technology from January 2018 to January 2022 were retrospectively collected and subsequently divided into a modeling group and a verification group. A univariate analysis was performed on the identified SAE risk factors, and then significant factors were included in the multivariate logistic regression model to screen for independent predictors of SAE. The receiver operating characteristic curve (ROC) and the Hosmer-Lemeshow test were used to evaluate the discrimination and calibration of the model, respectively.
UNASSIGNED: A SAE occurred in 69 (10.0%) of the 690 catheterization procedures meeting inclusion criteria. The established SAE risk calculation formula was logit(p) = -6.134 + 0.992 × pulmonary artery hypertension (yes) + 1.459 × disease severity (severe) + 2.324 × procedure type (diagnostic and interventional) + 1.436 × cTnI ( ≥ 0.028 μ g/L) + 1.537 × NT-proBNP ( ≥ 126.65 pg/mL). The total score of the final risk score model based on the effect size of each predictor was 0 to 7, involving pulmonary artery hypertension (1 point), disease severity (1 point), procedure type (2 points), cTnI (1 point) and NT-proBNP (2 points), and the score greater than 3 means high risk. The C-statistic of the area under the ROC curve was 0.840 and 0.911 for the derivation and validation cohorts, respectively. According to the Hosmer-Lemeshow test, the p values in the modeling group and the verification group were 0.064 and 0.868, respectively.
UNASSIGNED: The risk prediction model developed in this study has high discrimination and calibration, which can provide reference for clinical prediction and evaluation of SAE risk after cardiac catheterization in patients with moderate and severe ACHD.
UNASSIGNED: A total of 690 patients with moderate and severe adult patients with congenital heart disease (ACHD) who underwent cardiac catheterization in Wuhan Asian Heart Hospital Affiliated to Wuhan University of Science and Technology from January 2018 to January 2022 were retrospectively collected and subsequently divided into a modeling group and a verification group. A univariate analysis was performed on the identified SAE risk factors, and then significant factors were included in the multivariate logistic regression model to screen for independent predictors of SAE. The receiver operating characteristic curve (ROC) and the Hosmer-Lemeshow test were used to evaluate the discrimination and calibration of the model, respectively.
UNASSIGNED: A SAE occurred in 69 (10.0%) of the 690 catheterization procedures meeting inclusion criteria. The established SAE risk calculation formula was logit(p) = -6.134 + 0.992 × pulmonary artery hypertension (yes) + 1.459 × disease severity (severe) + 2.324 × procedure type (diagnostic and interventional) + 1.436 × cTnI ( ≥ 0.028 μ g/L) + 1.537 × NT-proBNP ( ≥ 126.65 pg/mL). The total score of the final risk score model based on the effect size of each predictor was 0 to 7, involving pulmonary artery hypertension (1 point), disease severity (1 point), procedure type (2 points), cTnI (1 point) and NT-proBNP (2 points), and the score greater than 3 means high risk. The C-statistic of the area under the ROC curve was 0.840 and 0.911 for the derivation and validation cohorts, respectively. According to the Hosmer-Lemeshow test, the p values in the modeling group and the verification group were 0.064 and 0.868, respectively.
UNASSIGNED: The risk prediction model developed in this study has high discrimination and calibration, which can provide reference for clinical prediction and evaluation of SAE risk after cardiac catheterization in patients with moderate and severe ACHD.
摘要：
■中国大约有200万成人先天性心脏病患者，中度和重度患者的数量正在增加。然而,很少有研究调查导管插入后严重不良事件(SAE)的风险.这项研究的目的是确定与心导管插入相关的SAE的危险因素，并提供预测SAE的风险评分模型。
■回顾性收集2018年1月至2022年1月在武汉科技大学附属武汉亚洲心脏医院行心导管插入术的中重度成人先天性心脏病(ACHD)患者690例，随后分为建模组和验证组。对已识别的SAE危险因素进行了单变量分析，然后将显著因素纳入多因素logistic回归模型以筛选SAE的独立预测因子.受试者工作特性曲线(ROC)和Hosmer-Lemeshow试验用于评估模型的鉴别和校准,分别。
■符合纳入标准的690例导管插入手术中有69例（10.0%）发生SAE。建立的SAE风险计算公式为logit（p）=-6.1340.992×肺动脉高压（是）+1.459×疾病严重程度（严重）+2.324×手术类型（诊断和介入）+1.436×cTnI（≥0.028μg/L）+1.537×NT-proBNP（≥126.65pg/mL）。基于各预测因子效应大小的最终风险评分模型总分为0~7分,涉及肺动脉高压(1分),疾病严重程度（1分），程序类型（2分），cTnI（1分）和NT-proBNP（2分），得分大于3表示高风险。推导和验证队列的ROC曲线下面积的C统计量为0.840和0.911，分别。根据Hosmer-Lemeshow测试,模型组和验证组的p值分别为0.064和0.868.
■本研究建立的风险预测模型具有很高的辨别力和校准性，可为临床预测和评估中重度ACHD患者心导管术后SAE风险提供参考。
■回顾性收集2018年1月至2022年1月在武汉科技大学附属武汉亚洲心脏医院行心导管插入术的中重度成人先天性心脏病(ACHD)患者690例，随后分为建模组和验证组。对已识别的SAE危险因素进行了单变量分析，然后将显著因素纳入多因素logistic回归模型以筛选SAE的独立预测因子.受试者工作特性曲线(ROC)和Hosmer-Lemeshow试验用于评估模型的鉴别和校准,分别。
■符合纳入标准的690例导管插入手术中有69例（10.0%）发生SAE。建立的SAE风险计算公式为logit（p）=-6.1340.992×肺动脉高压（是）+1.459×疾病严重程度（严重）+2.324×手术类型（诊断和介入）+1.436×cTnI（≥0.028μg/L）+1.537×NT-proBNP（≥126.65pg/mL）。基于各预测因子效应大小的最终风险评分模型总分为0~7分,涉及肺动脉高压(1分),疾病严重程度（1分），程序类型（2分），cTnI（1分）和NT-proBNP（2分），得分大于3表示高风险。推导和验证队列的ROC曲线下面积的C统计量为0.840和0.911，分别。根据Hosmer-Lemeshow测试,模型组和验证组的p值分别为0.064和0.868.
■本研究建立的风险预测模型具有很高的辨别力和校准性，可为临床预测和评估中重度ACHD患者心导管术后SAE风险提供参考。
