Abstract: Objective This study aimed to explore the risk factors for neurological complications in patients with liver cancer after transarterial chemoembolization (TACE), and to construct and validate a predictive model.Methods A total of 300 patients with liver cancer who underwent TACE treatment for the first time from January 2022 to September 2025 were selected.They were divided into the complication group (51 cases) and the non-complication group (249 cases) based on whether neurological complications occurred within 30 days after the operation.Logistic regression was used to screen independent influencing factors, a nomogram model was constructed, and the model's efficacy was evaluated using the receiver operating characteristic (ROC) curve, calibration curve, and decision curve (DCA).Results The incidence of neurological complications after TACE was 17.00%.Multivariate Logistic regression analysis showed that the Eastern Cooperative Oncology Group (ECOG) score, operation time, alpha-fetoprotein (AFP), abnormal prothrombin (DCP), and C-reactive protein (CRP) were independent risk factors, while platelet count was a protective factor (P<0.05).The area under the curve (AUC) of the nomogram model based on these 6 indicators was 0.906 (95%CI: 0.865-0.947), the calibration curve fitted well (Hosmer-Lemeshow test P=0.691), and the decision curve showed that the model had good clinical net benefit within the probability range of 0.05-0.90.Conclusion ECOG score, operation time, AFP, DCP, CRP, and platelet count are the key influencing factors for neurological complications in patients with liver cancer after TACE.The constructed nomogram model has good predictive efficacy and clinical practicability, and can be used for the screening of high-risk patients.

Key words: liver cancer; transarterial chemoembolization; neurological complications; influencing factors