Analysis of risk factors and construction of a nomogram prediction model for early hemoptysis following 125I seed implantation in patients with advanced lung cancer
Cohort study reveals key predictors of early hemoptysis after iodine-125 seed implantation in advanced lung cancer, suggesting a nomogram can guide preventive hemostatic care.
Key Points
To identify independent clinical risk factors for early hemoptysis following iodine-125 seed implantation and construct a predictive nomogram model for advanced lung cancer patients.
Retrospective cohort analysis of N=133 advanced lung cancer patients undergoing iodine-125 seed implantation between August 2023 and May 2025 at a single center in China.
Patients were grouped by occurrence of postoperative hemoptysis (n=31) versus no hemoptysis (n=102), followed by binary logistic regression to determine risk factors and nomogram construction evaluated via ROC, calibration, and decision curve analyses.
Postoperative hemoptysis occurred in 23.3% (31/133) of patients, with independent risk factors identified as right hilar lesion location (OR: 10.831, 95% CI: 2.537–46.232), chemotherapy history (OR: 3.138, 95% CI: 1.160–8.488), and intrathoracic bleeding (OR: 2.666, 95% CI: 1.016–6.993).
Prothrombin time was negatively correlated on multivariate analysis (OR: 0.507, 95% CI: 0.280–0.918), although values remained within normal physiological ranges.
The predictive nomogram achieved an area under the ROC curve of 0.830 (95% CI: 0.753–0.907), providing 93.5% sensitivity and 65.7% specificity at a 0.155 cutoff, with confirmed clinical net benefit across a 0.02–0.70 threshold probability range.