Objective To explore the risk factors for the occurrence of hypoglycemia in patients with interventional operation for primary hepatocellular carcinoma (PHC), and to construct a risk prediction model. Methods A total of 543 patients with interventional operation for PHC were selected as the research subjects, and they were assigned to training group (380 cases) or validation group (163 cases) according to admission time. Patients of the training group were further divided into hypoglycemia or non⁃hypoglycemia group according to the presence of hypoglycemia occurred within 3 months after interventional operation. General data of patients in both groups were compared. Multivariate Logistic regression model was adopted to analyze the risk factors for patients with interventional operation suffering from hypoglycemia, and the risk prediction model was constructed based on the risk factors. The Hosmer⁃Lemeshow (H⁃L) test was employed to validate the goodness of fit of the model. Receiver operating characteristic (ROC) curve, calibration curve and decision curve analysis curve were plotted to evaluate the discrimination, calibration, and clinical applicability of the model, respectively. Data of the validation group was used to perform external validation. Results A total of 138 (25.41%) PHC patients suffered from hypoglycemia after interventional operation, therein 97 (25.53%) in the training group, and 41 (25.15%) in the validation group. In the training group, there were statistically significant differences in age, body mass index, educational level, ascites proportion, diarrhea proportion, Child⁃Pugh classification, proportion of hypoglycemia history, HbA1c, serum albumin, diet status, preoperative fasting time between the non⁃hypoglycemia group and the hypoglycemia group (P<0.05). The results of multivariate Logistic regression analysis revealed that PHC patients undergoing interventional operation with age >60 years, low body mass index, low educational level, high Child⁃Pugh classification, suffering from hypoglycemia history, low HbA1c, irregular meals, preoperative fasting time >10 hours were the risk factors for the occurrence of hypoglycemia in PHC patients after interventional operation (P<0.05). The risk prediction model was constructed based on these aforementioned risk factors, and H⁃L test results indicated that the goodness of fit of the model was relatively favorable, and accuracy was relatively high. Areas under the ROC curve of the training and validation groups were 0.902 and 0.880. The ideal curve of the training group and the validation group closely matched the actual curve, and the net benefit values obtained from both internal and external validations were relatively high. Conclusion The incidence rate of hypoglycemia after interventional operation in patients with PHC is relatively high. Aged >60 years, low body mass index, low educational level, high Child⁃Pugh classification, suffering from hypoglycemia history, low HbA1c, irregular meals, and preoperative fasting time >10 hours are risk factors for hypoglycemia occurred in PHC patients after interventional operation. The risk prediction model constructed based on these risk factors exerts good predictive effect and high clinical application value, which is helpful for clinical medical and nursing personnel to evaluate the risk of hypoglycemia occurred in such patients after interventional operation.

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