Development and Validation of a Nomogram to Predict Recurrence of Primary Hyperhidrosis after CT-guided Percutaneous Radiofrequency Sympathectomy

Abstract

PurposeTo evaluate the recurrence rate of primary hyperhidrosis (PH) after computed tomography (CT)-guided radiofrequency sympathectomy (RFS) and identify risk factors associated with recurrence. Materials and MethodsA total of 290 patients with PH who underwent CT-guided RFS were included in this retrospective cohort study. The electronic medical record was reviewed for patients’ information and procedural parameters. Follow-ups were conducted for recurrence rate, and Hyperhidrosis Disease Severity Scale was used to assess presence or absence of recurrence. Stepwise regression and the least absolute shrinkage and selection operator regression algorithms were used for feature selection. ResultsThe recurrence rate 1 year after procedure was 17.6%. Male (hazard ratio [HR], 2.35; 95% confidence interval [CI], 1.08–5.15), low postoperative palm or foot temperature (HR, 0.77; 95% CI, 0.60–0.98), high postoperative heart rate (HR, 1.06; 95% CI, 1.02–1.10), low preoperative and postoperative hospital anxiety and depression score difference (HR, 0.59; 95% CI, 0.43–0.80), and the absence of compensatory hyperhidrosis immediately after procedure (HR, 0.46; 95% CI, 0.22–0.98) were established as independent factors affecting prognosis. A nomogram was built accordingly. The C indices of the training and testing sets were 0.773 and 0.659, respectively. ConclusionsFollow-up results showed that the recurrence rate of PH treated with CT-guided RFS was low. This study constructed and validated a nomogram to predict the recurrence of PH 1 year after CT-guided RFS, which is convenient for interventionalists to evaluate accurately the prognosis of patients postoperatively and to identify high-risk patients who need more active treatment.