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The Application of A Risk Prediction Model for Arteriovenous Fistula Complications Based on Color Doppler Ultrasound and Clinical Multi Parameters prediction model is used in clinical practice
Received date: 2024-12-17
Revised date: 2025-04-23
Accepted date: 2025-08-02
Online published: 2025-08-06
Supported by
《 基于“个案管理”下血液透析患者血管通路全程管理模式的构建与实施》(ZX20207)
Objective： To investigate the risk factors for complications of autologous arteriovenous fistula （AVF） in maintenance hemodialysis （MHD） patients and construct a risk prediction model to guide interventions for reducing complication.Methods： A retrospective analysis was conducted on the clinical data of 259 MHD patients who underwent AVF surgery in the department of nephrology of our hospital from January 2020 to December 2023. The vascular color Doppler ultrasound parameters and clinical data of the patients were collected. The patients were divided into the complication group and the normal group according to whether complications occurred. Univariate and multivariate Logistic regression analyses were performed to identify the risk factors influencing the occurrence of complications， and the regression equations were obtained. The results were imported into R software to generate a visual Nomogram model， draw the receiver operating characteristic （ROC） curve and calibration curve， and evaluate the discrimination and accuracy of the predictive model for the risk of AVF complications in MHD patients.Results： Among the 259 patients， 73 cases （accounting for 28.18%） were in the complication group and 186 cases （accounting for 71.82%） were in the normal group. Multivariate analysis identified the following independent risk factors： radial artery peak systolic velocity （PSV） （β = -0.082， 95% CI： 0.867-0.980， P = 0.009）， radial artery diameter （β = -1.800， 95% CI： 0.052-0.134， P = 0.005）， cephalic vein blood flow （β = -0.058， 95% CI： 0.893-0.997， P = 0.038）， and fasting blood-glucose （β = 0.084， 95% CI： 0.922-1.003， P = 0.035）. The area under the ROC curve （AUC） is 0.986 （95% CI： 0.974-0.998）. The slope of the calibration curve is close to 1， and the mean absolute error （MAE） is 0.015. Conclusion： The predictive model integrating color Doppler ultrasound and multivariate clinical parameters can play an important role in evaluating the occurrence of complications of AVF. The clinical application of this model enables early risk stratification and targeted interventions to reduce complication incidence.
Zhang-Qi-Fang
.
The Application of A Risk Prediction Model for
Arteriovenous Fistula Complications Based on Color Doppler Ultrasound and
Clinical Multi Parameters
prediction model is used in clinical practice
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