Development and validation of a predictive scoring system for post-transarterial chemoembolization pain management in liver cancer patients

作者全名：You, Ke; Wang, Jiaguo; Xu, Jie; Zhang, Chunyu; Wang, Xingxing; Gavriilidis, Paschalis; Kawaguchi, Takumi; Wang, Yunbing

作者地址：[You, Ke; Wang, Jiaguo; Xu, Jie; Zhang, Chunyu; Wang, Xingxing; Wang, Yunbing] Chongqing Med Univ, Affiliated Hosp 2, Dept Hepatobiliary Surg, 76 Linjiang Rd, Chongqing 400010, Peoples R China; [Gavriilidis, Paschalis] Colchester Gen Hosp, Dept Surg, Colchester, England; [Kawaguchi, Takumi] Kurume Univ, Sch Med, Dept Med, Div Gastroenterol, Kurume, Japan

通信作者：Wang, YB (通讯作者)，Chongqing Med Univ, Affiliated Hosp 2, Dept Hepatobiliary Surg, 76 Linjiang Rd, Chongqing 400010, Peoples R China.

来源：JOURNAL OF GASTROINTESTINAL ONCOLOGY

ESI学科分类：CLINICAL MEDICINE

WOS号：WOS:001222153000016

JCR分区：Q3

影响因子：2

年份：2024

卷号：15

期号：1

开始页：425

结束页：434

文献类型：Article

关键词：Transarterial chemoembolization (TACE); pain; risk factors; predict; scoring system

摘要：Background: Patients experiencing severe postoperative pain often show lower adherence to prescribed treatments, highlighting the clinical need for effective pain prediction and management strategies. This study aims to address this gap by identifying key risk factors associated with post-transarterial chemoembolization (TACE) pain and developing a predictive scoring system. Methods: We retrospectively analyzed data from liver cancer patients who underwent their first TACE procedure at our institution between January 2019 and December 2020. Pain levels were assessed using an 11-point numerical rating scale (NRS-11). Patients were randomly assigned to training and validation cohorts. In the training cohort, logistic regression was used to evaluate the correlation between various parameters and post-TACE pain, leading to the development of a risk prediction model. This model's performance was subsequently assessed in the validation cohort. Results: The study included 255 patients. Univariate analysis in the training cohort identified tumor number, size, microsphere volume, and operation time as factors associated with postoperative pain. These factors were included in a multivariate model, which demonstrated areas under the receiver operating characteristic (ROC) curve (AUCs) of 0.71 in the training cohort and 0.74 in the validation cohort for predicting moderate to severe pain. A nomogram was also developed for clinical application, categorizing patients with scores above 72.90 as high risk for moderate to severe pain. Conclusions: Our research successfully developed and validated a novel scoring system capable of predicting moderate to severe pain following initial TACE treatment. However, the study's predictive accuracy, as reflected by AUC values, suggests that further refinement and validation in larger, diverse cohorts are necessary to enhance its clinical utility. This work underscores the importance of predictive tools in improving postoperative pain management and patient outcomes.

基金机构：Chongqing Medical Scientific Research Project (Joint Project of Chongqing Health Commission and Science and Technology Bureau) [2021MSXM139]; Postdoctoral Science Foundation of Chongqing Natural Science Foundation [cstc2020jcyj-bshX0033]

基金资助正文：The study was funded by the Chongqing Medical Scientific Research Project (Joint Project of Chongqing Health Commission and Science and Technology Bureau) (No. 2021MSXM139) and the Postdoctoral Science Foundation of Chongqing Natural Science Foundation (No. cstc2020jcyj-bshX0033) .