0 44

A risk prediction model for medical treatment failure in tubal pregnancy

Authors
 Jae Hoon Lee  ;  Sunghoon Kim  ;  Inha Lee  ;  Jisun Yun  ;  Bo Hyon Yun  ;  Young Sik Choi  ;  Byung Seok Lee  ;  Seok Kyo Seo 
Citation
 European Journal of Obstetrics & Gynecology and Reproductive Biology, Vol.225 : 148-154, 2018 
Journal Title
 European Journal of Obstetrics & Gynecology and Reproductive Biology 
ISSN
 0301-2115 
Issue Date
2018
Keywords
Medical treatment failure ; Methotrexate treatment ; Risk prediction model ; Tubal pregnancy
Abstract
OBJECTIVE: Methotrexate is an alternative treatment for tubal pregnancy. However, despite initial treatment, approximately 15% of women eventually require surgery. This study aimed to identify the risk factors for medical treatment failure in tubal pregnancy and apply them to a risk prediction model. STUDY DESIGN: This single-center retrospective cohort study included 123 participants initially treated medically for tubal pregnancy between January 2006 and December 2015. Logistic regression analysis was used to construct a risk prediction model (visually presented as a nomogram) for medical treatment failure. Model performance was assessed using discrimination and calibration. The medical treatment failure rate was 36.6%. The prediction model integrated the presence of a gestational sac, ectopic mass size, and follow-up beta-human chorionic gonadotropin levels above cut-off values on days 4 and 7. The model used the following cut-off values: increased beta-human chorionic gonadotropin levels by 1028.6 mIU/mL, 1.0457-fold higher than baseline level on day 4; and increased beta-human chorionic gonadotropin levels by 1233 mIU/mL, 1.3025-fold higher than baseline level on day 7. RESULTS: The corresponding areas under the receiver-operating characteristic curves were 0.8135 (95% confidence interval, 0.733-0.893) for the day 4 model and 0.8600 for the day 7 model (95% confidence interval, 0.788-0.932). Comparison of the day 4 and 7 models revealed no significant difference in their predictive abilities (P=0.4318). CONCLUSIONS: This model identified a substantial proportion of the participants who experienced medical treatment failure for tubal pregnancy. It was visualized as a nomogram, facilitating clinical application.
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/162379
Full Text
https://www.sciencedirect.com/science/article/pii/S0301211518301866
DOI
10.1016/j.ejogrb.2018.04.020
Appears in Collections:
1. Journal Papers (연구논문) > 1. College of Medicine (의과대학) > Dept. of Obstetrics and Gynecology (산부인과학교실)
Yonsei Authors
김성훈(Kim, Sung Hoon)
서석교(Seo, Seok Kyo) ORCID logo https://orcid.org/0000-0003-3404-0484
윤보현(Yun, Bo Hyon) ORCID logo https://orcid.org/0000-0001-5703-797X
윤지선(Yun, Jisun)
이병석(Lee, Byung Seok)
이인하(Lee, Inha)
이재훈(Lee, Jae Hoon)
최영식(Choi, Young Sik)
Export
RIS (EndNote)
XLS (Excel)
XML
사서에게 알리기
  feedback

qrcode

Items in DSpace are protected by copyright, with all rights reserved, unless otherwise indicated.

Browse