Establishment Of Nomogram For Predicting Postoperative Complications Of Two Types Of Hepatic Echinococcosis

Objective:By analyzing the risk factors related to PHC in both type s of hepatic echinococcosis,a nomogram risk prediction model was establishe d to predict the risk of PHC,and its clinical value was evaluated,so as to b etter guide perioperative clinical decision-making.Methods:The clinical data of 263 patients with two types of hepatic echinococcosis who underwent hepatectomy in the affiliated Hospital of Qinghai University from January 2015 to August 2020 was collected retrospectively.Univariate and multivariate Logistic regression were used to screen the IRF of PHC.According to the weight of IRF,the NRPM was built.Bootstrap resampling method was used for internal verification of the model,ROC working curve was constructed to evaluate the differentiation of the model,calibration curve and Hosmer-Lemeshow test were used to evaluate the consistency of the model,and DCA was drawn to analyze and verify the clinical effectiveness of the model.Results:Among the 263 patients with hepatic echinococcosis who underwent hepatectomy,93 cases(35.36%)had PHC.ALBI(OR=3.694,95%CI:1.860～7.336),operation time operation time(OR=2.848,95%CI:1.384～5.859),intraoperative blood loss(OR=4.832,95%CI:2.384～9.793)and hydatid diameter(OR=3.073,95%CI:1.528～6.177)were the IRF of PHC in two types of hepatic echinococcosis.Based on the weights of the above four IRF,a NRPM was constructed,and the AUROC of the model was 0.877(95%CI: 0.831 ～ 0.923).The C-index of internal verification by Bootstrap resampling method was 0.871,indicating good differentiation of the model.The fitting of the observed value and the actual value of the calibration curve and the Hosmer-Lemeshow test showed that the predicted value of the NRPM was in good agreement with the actual observed value.When the threshold probability is 35.6%,the clinical net benefit shown by DCA was 22%,it has good clinical applicability in the threshold probability range of 8% rape 89%.Conclusion:ALBI score,operation time,intraoperative blood loss and hydatid diameter are the IRF of PHC in patients with two types of hepatic echinococcosis.The NRPM has good accuracy,consistency and clinical practicability.Thus,it can better guide perioperative clinical decision-making and reduce the incidence of PHC.