Development and evaluation of a nutritional risk prediction model for patients with hepatocellular carcinoma
Chun-Xia Chen1, Xiang-Fan Chen2, Tian-Le Wang1
1Department of Medical Imaging, The Second Affiliated Hospital of Nantong University, Nantong, 226001, Jiangsu, China.
Abstract:
To study the risk factors for malnutrition in patients with hepatocellular carcinoma undergoing transarterial chemoembolisation (TACE), construct a risk prediction model and evaluate its predictive effectiveness. A retrospective study was conducted, selecting 194 cases of patients with liver cancer who received their first TACE treatment in the interventional department of a tertiary first-class hospital in Nantong, Jiangsu Province, between January 2019 and December 2023. General data and factors related to malnutrition were retrospectively collected, and the occurrence of malnutrition within 3 months following TACE surgery was observed. Univariate analysis and multivariate logistic regression analysis were performed on the data, a predictive model was constructed and the model performance was evaluated using the Hosmer-Lemeshow (HL) test and receiver operating characteristic (ROC) curve analysis. The incidence of malnutrition was 36.08%. Multivariate logistic regression analysis showed that haemoglobin (Hb) (P = 0.048, odds ratio [OR] = 0.971), age (P = 0.017, OR = 1.068), Child-Pugh (CP) class score (P = 0.000, OR = 11.780), L3-psoas muscle index (L3-PMI) (P = 0.036, OR = 0.062) and albumin (ALB) (P = 0.000, OR = 0.804) were independent risk factors for malnutrition. The area under the ROC curve of the constructed model was 0.958, indicating its strong predictive power. The HL goodness-of-fit test (P > 0.05) suggested that the model fit was good. Advanced age, high CP grade, low L3-PMI, low ALB and low Hb are independent risk factors for malnutrition in patients undergoing TACE for liver cancer. The constructed model can provide a scientific basis for nutritional management of patients.
