Development And Validation Of A Prediction Recurrence Model For Primary Spontaneous Pneumothorax

Objective: To analyze the risk factors of primary spontaneous pneumothorax recurrence and establish a prediction model to guide clinicians to evaluate the risk of pneumothorax recurrence individually.Methods: The clinical data of 803 patients diagnosed with primary spontaneous pneumothorax in the First Affiliated Hospital of Xinjiang Medical University from January 2010 to January 2021 were retrospectively analyzed,and 70% of the patients were randomly included in the modeling cohort(562patients)and 30% in the validation cohort(241 patients).Risk factors for recurrence were analyzed by univariate and multivariate Cox regression using R 4.2.1 software,and a Nomogram prediction model was developed.Receiver operating characteristic curves were plotted,and the area under the curve was calculated to assess the discrimination of model,and calibration curves were plotted to assess the calibration of model.Results: The overall recurrence rate of patients included in this research was 22.67%(182/803),with a recurrence rate of 19.2% corresponding to surgical treatment and 33.86% for non-surgical treatment.117 patients(64.29%)experienced recurrence within the first year of follow-up,and the follow-up period ranged from 2 weeks to 10 years.According to the results of univariate analysis,age,height,body mass index,dystrophic severity score and treatment regimens were statistically associated with primary spontaneous pneumothorax recurrence,while multivariate analysis showed that age,smoking index,dystrophic severity score and treatment regimens were independent risk factors for primary spontaneous pneumothorax recurrence(P < 0.05).The Nomogram prediction model was constructed based on the independent risk factors for primary spontaneous pneumothorax recurrence,and the area under the receiver operating characteristic curves of the model was 71.7%(95% CI 64.1 ～79.2),with reasonable predictive effect.Conclusion: The recurrence prediction model of primary spontaneous pneumothorax developed in this study can assist clinicians to accurately assess the risk of recurrence in individual patients and has good clinical significance.