ArticleFrontiers in medicine2025
Development and validation of a nomogram for predicting bleeding risk in patients with pulmonary embolism.
Article in Frontiers in medicine, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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4 authors.
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Abstract
Purpose: Bleeding during anticoagulation therapy represents a critical challenge in pulmonary embolism (PE) management, this study aimed to develop and validate a PE-specific bleeding risk prediction model. Methods: This retrospective cohort study utilized a clinical research big data platform, including 5,632 hospitalized PE patients (January 2013-December 2024). Significant bleeding within 6 months served as the primary outcome. After excluding variables with >20% missingness, 29 predictors were analyzed. The cohort was randomly split into development ( Results: The final model identified six predictors: prior bleeding history, renal insufficiency, red blood cell count, systolic pressure, cerebral infarction, and creatinine. The model demonstrated robust discrimination (development AUC: 0.756, 95%CI: 0.729-0.784; validation AUC: 0.729, 95%CI: 0.685-0.773) and calibration (validation slope: 0.810). DCA confirmed significant net benefit at 5-35% thresholds, with 30% as the optimal cut-off. At this threshold, the model reduced major bleeding by 42% versus standard care. Conclusion: This novel PE-specific bleeding risk tool provides clinically actionable stratification, enabling personalized anticoagulation intensity adjustment. Implementation may reduce hemorrhage-related morbidity while optimizing resource utilization.
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