Scholarlink

Objectives <p>To create a nomogram for early intra-abdominal hypertension (IAH) detection in pediatric patients following liver transplantation (LT).</p> Methods <p>This prospective, observational study was conducted in a tertiary hospital’s Liver Transplantation Intensive Care Unit (LICU), prospectively recruiting a cohort of 425 children undergoing liver transplantation between January 2022 and December 2024. Perioperative parameters were electronically extracted via the hospital information system. Intra-abdominal pressure (IAP) quantification employed the standardized transvesical technique. To identify clinically relevant predictors, a LASSO-based feature selection algorithm was applied, leveraging regularization to shrink coefficients of non-informative variables toward zero. The retained covariates were then integrated into a multivariable logistic regression model for nomogram construction. Internal validation included three domains: (1) discrimination performance evaluated by area under the ROC curve (AUC), (2) calibration accuracy by Hosmer-Lemeshow test with calibration curves, and (3) clinical utility assessed through decision curve analysis (DCA) across probability thresholds.</p> Results <p>Three independent predictors were identified: Graft-to-Recipient Weight Ratio (GRWR), duration of mechanical ventilation (MV), and central venous pressure (CVP), integrated into a predictive nomogram. DCA showed a significant net benefit, and temporal validation confirmed the nomogram’s reliability. The nomogram displayed superior predictive accuracy (AUC = 0.831) with adequate calibration (Hosmer-Lemeshow test <i>p</i> &gt; 0.05). DCA revealed favorable clinical applicability across threshold probabilities, showing positive net benefit values ranging from 10%−80% and 5%−80%, while temporal validation maintained discriminative capacity (AUC = 0.822).</p> Conclusions <p>The study devised an effective nomogram for identifying pediatric patients at a heightened risk of IAH following LT, incorporating GRWR, duration of MV and CVP.</p>

错误：搜索内容不能为空，请输入英文关键词
错误：关键词超出字数限制，请精简
高级检索

A nomogram for predicting postoperative intra-abdominal hypertension in pediatric patients following liver transplantation: a prospective observational study

  • 期刊论文

  • 出版模式：

    开放获取

  • 发表日期：

    2025年12月19日

查看全文
  • ZhiRu Li,
  • FangYan Lu,
  • YanHong Dai,
  • Li Ji,
  • HaiLi Huang,
  • PanPan He,
  • WanYing Zhang,
  • HuaFen Wang

摘要

Objectives

To create a nomogram for early intra-abdominal hypertension (IAH) detection in pediatric patients following liver transplantation (LT).

Methods

This prospective, observational study was conducted in a tertiary hospital’s Liver Transplantation Intensive Care Unit (LICU), prospectively recruiting a cohort of 425 children undergoing liver transplantation between January 2022 and December 2024. Perioperative parameters were electronically extracted via the hospital information system. Intra-abdominal pressure (IAP) quantification employed the standardized transvesical technique. To identify clinically relevant predictors, a LASSO-based feature selection algorithm was applied, leveraging regularization to shrink coefficients of non-informative variables toward zero. The retained covariates were then integrated into a multivariable logistic regression model for nomogram construction. Internal validation included three domains: (1) discrimination performance evaluated by area under the ROC curve (AUC), (2) calibration accuracy by Hosmer-Lemeshow test with calibration curves, and (3) clinical utility assessed through decision curve analysis (DCA) across probability thresholds.

Results

Three independent predictors were identified: Graft-to-Recipient Weight Ratio (GRWR), duration of mechanical ventilation (MV), and central venous pressure (CVP), integrated into a predictive nomogram. DCA showed a significant net benefit, and temporal validation confirmed the nomogram’s reliability. The nomogram displayed superior predictive accuracy (AUC = 0.831) with adequate calibration (Hosmer-Lemeshow test p > 0.05). DCA revealed favorable clinical applicability across threshold probabilities, showing positive net benefit values ranging from 10%−80% and 5%−80%, while temporal validation maintained discriminative capacity (AUC = 0.822).

Conclusions

The study devised an effective nomogram for identifying pediatric patients at a heightened risk of IAH following LT, incorporating GRWR, duration of MV and CVP.