Factors influencing forearm swelling after transradial artery intervention and establishment of a predictive model: a prospective study

Abstract Aims Forearm swelling is a common complication following transradial artery interventions. Identifying the factors that influence this swelling and developing predictive models for it are crucial yet underexplored issues. This study was performed to investigate the risk factors for forearm swelling after transradial artery puncture and construct a predictive model. Methods and results In total, 209 inpatients who underwent coronary angiography and/or interventional therapy at a tertiary hospital in Beijing between June and November 2023 were consecutively enrolled in this prospective study. The patients were divided into two groups: those who developed forearm swelling after puncture (swelling group) and those who did not (non-swelling group). The groups were compared, and logistic regression was used to identify risk factors for forearm swelling. The predictive accuracy of the model was evaluated using receiver operating characteristic analysis and the area under the curve. Among the 209 patients [132 (63.2%) men, 77 (36.8%) women], 27 developed forearm swelling. Independent predictors of swelling were the operation time, radial artery access, irregular tourniquet compression, number of tourniquet compressions, inappropriate wrist movement, and timing of the first tourniquet deflation. The predictive model achieved an area under the curve of 0.971 (95% confidence interval, 0.949–0.992). Conclusion This single-centre diagnostic study demonstrated that the predictive model has excellent accuracy. Its application could help prevent unnecessary forearm swelling following radial artery interventions.