Risk Factors And Prediction Model Of Thrombocytopenia After Patent Ductus Arteriosus Transcatheter Occlusion

Objective:To analyze the risk factors of thrombocytopenia after patent ductus arteriosus transcatheter occlusion and build prediction model.Methods:358 Children treated with transcatheter closure of patent ductus arteriosus were collected in Children's Hospital of Chongqing Medical University form January 2017 to September 2018.To find out the risk factors of thrombocytopenia and build prediction model.Results:After a series of statistical analysis,we identified the influencing factors of thrombocytopenia were consist of:wight?body surface area?preoperative platelet count?diameter of defect?pressure difference?pulmonary arterial hypertension?two-way shunt?diameter of occluder?diameter of radiography?pulmonary arterial pressure of radiography?residual shunt?diameter of occluder/body surface area.The risk facors include:preoperative platelet count(B=0.007,95%CI:0.004~0.01,P<0.001),pulmonary arterial hypertension(B=1.217,95%CI:0.324~2.109,P=0.008),residual shunt(B=2.099,95%CI:1.187~3.012,P<0.001).The prediction model of severe thrombocytopenia:(?)(4)(PAH:yes=1,no=0;RS:yes=1,no=0).Describe the ROC curve to test the Logistic equation:the area under the ROC curve=0.918±0.018,the95%confidience interval was 0.882~0.954,set 0.5 as the cut-off point.The sentivity of predicting serve thrombocytopenia after patent ductus arteriosus transcatheter occlusion was 86.1%,the specificity was 84.9%.Conclusions:Thrombocytopenia is a common complication after patent ductus arteriosus transcatheter occlusion.,Incidence rate was 86.6%,among the 358 casess,the group of no thrombocytopenia had 48 cases(13.4%),the group of mild thrombocytopenia had 65 cases(18.2%),the group of moderate thrombocytopenia had 209 cases(58.4%),the group of serve thrombocytopenia had 36 cases(2.5%),and cases of platelet count<100×10~9/L were 9(10%).The independent risk facors include:preoperative platelet count?pulmonary arterial hypertension?residual shunt.The predict model has certain high sensitivity and specificity,so has a quite clinical value in predicting serve thrombocytopenia after patent ductus arteriosus transcatheter occlusion.