Wang reported a nomogram for predicting difficult hemostasis with hemorrhage following endobronchial biopsy in a lung cancer patient. This can help to identify a patient who may require more aggressive management. The author is from Jinhua Municipal Central Hospital in China.
Patient selection: lung cancer patient status post endobronchial biopsy
Parameters:
(1) histologic type of lung cancer
(2) lesion location
(3) pulmonary infection
(4) aPTT in seconds
(5) percent neutrophils in the differential count
(6) serum LDL-C in mmol/L
(7) serum ApoE in mg/dL
points for aPTT =
= (0.8967 * (aPTT)) - 8.9667
points for percent neutrophils =
= (0.455 * (percent))
points for LDL cholesterol =
= (10.954 * (LDLC)) - 10.954
points for serum ApE =
= 100 - (5.555 * (ApoE))
|
Parameter
|
Finding
|
Points
|
|
histological type
|
adenocarcinoma
|
0
|
|
|
squamous cell carcinoma
|
29
|
|
|
small cell carcinoma
|
12.8
|
|
|
other
|
4.5
|
|
lesion location
|
left main bronchus
|
20.4
|
|
|
left upper lobe bronchus
|
6.4
|
|
|
left lower lobe bronchus
|
8.8
|
|
|
right main bronchus
|
34.2
|
|
|
right upper lobe bronchus
|
7.3
|
|
|
right middle lobe bronchus
|
24.4
|
|
|
right middle lobar bronchus
|
1.8
|
|
|
right lower lobe bronchus
|
0
|
|
|
trachea
|
31.2
|
|
pulmonary infection
|
no
|
0
|
|
|
yes
|
15.4
|
total score =
= SUM(points for all of the parameters)
Interpretation:
• maximum score: 349.1
value of X =
= (0.06719 * (score)) - 15.14
probability of difficult hemostasis =
= 1 / (1 + EXP((-1) * X))
Performance:
• The area under the ROC curve is 0.82.
