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与治疗未破裂的内动脉瘤 (MARTA) 相关的风险评分:发展和外部验证
Francesco Diana1,2,3, Adnan H Siddiqui4, Vinay Jaikumar4
1Interventional Neuroradiology, Vall d'Hebron University Hospital, Barcelona, Spain.
Neurosurgery
|January 14, 2026
概括
新的风险评分,MARTA-EVT和MARTA-NT,预测未破裂内动脉瘤 (UIA) 治疗的并发症. 这些经过验证的工具有助于管理UIA并指导患者的临床决策.
科学领域:
- 神经外科 神经外科
- 内血管外科 血管内血管外科
- 医疗信息学 医疗信息学
背景情况:
- 不破裂的内动脉瘤 (UIA) 越来越多地被检测到,需要谨慎管理以防止破裂.
- 目前的管理层缺乏外部验证的得分来预测治疗决策的程序风险.
- 常规的临床和动脉瘤特征可能会预测治疗并发症.
研究的目的:
- 开发和验证UIAs的内血管治疗 (EVT) 或神经外科治疗 (NT) 后并发症的预测得分.
- 为了比较新的得分与现有模型的性能.
主要方法:
- 在15个神经血管中心 (2014-2024) 进行了2647名UIA患者通过EVT或NT接受治疗的多中心回顾性研究.
- 使用多变量逻辑回归构建了预测模型 (UIAs治疗中的患病率和死亡率相关风险 - MARTA-EVT和MARTA-NT).
- 内部验证使用了引导,外部验证是临时和机构执行的. 使用AUROC和校准来评估性能.
主要成果:
- 程序性并发症发生在6.3%的EVT和12.8%的NT病例中.
- 马尔塔-EVT (AUROC = 0.68) 和马尔塔-NT (AUROC = 0.65) 显示了中度的歧视和良好的校准.
- 马尔塔-EVT的表现优于现有车型,而马尔塔-NT的表现与SAFETEA相似. 预测模型是可用的开源.
结论:
- MARTA-EVT和MARTA-NT是验证的工具,用于预测UIA治疗相关的程序风险.
- 这些分数可以支持患者咨询和神经血管护理中的临床决策.
- 开源的可用性促进了更广泛的采用和进一步的研究.
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