Uterine arteriovenous malformation (AVM)/Enhanced myometrial vascularity(EMV): Risk Prediction Model for Life-Threatening Major Bleeding - A Multicenter Clinical Study

Objective : To develop a risk prediction model for identifying high-risk cases of uterine AVM/EMV. Methods : A retrospective analysis was conducted on 191 patients with uterine AVM/EMV from multiple hospitals in Anhui Province and Qinghai Province between June 2009 and June 2024. Patients were categorized into two groups based on vital signs: 60 cases with life-threatening massive bleeding and 131 without. Logistic regression analysis identified predictors for life-threatening bleeding. Results : Univariate logistic regression showed that age, fibrinogen (FIB), AVM size, and AVM peak systolic velocity (AVM-PSV) were significantly associated with fatal bleeding (P<0.05). Multivariate analysis confirmed that only age and AVM-PSV remained significant (P<0.05). The model's AUC was 0.888 (95% CI: 0.843-0.934), with sensitivity and specificity both at 80%. The Hosmer-Lemeshow test indicated good calibration (P=0.661), and the clinical decision curve showed net benefit. Conclusion : The model using age and AVM-PSV provides excellent predictive value for fatal uterine AVM/EMV bleeding, aiding clinicians in assessing risk and identifying high-risk patients.