摘要
目的:探讨急性缺血性脑卒中(AIS)患者1年发生预后不良的危险因素,并建立其列线图风险预测模型。方法:通过西安脑卒中数据库平台,连续收集本市4所三级甲等医院2015年1~12月入院的AIS患者,并在入院确诊后随访1年。采用单因素和多因素Logistic回归分析,探讨AIS患者1年预后不良的相关危险因素,采用R软件及rms程序包构建AIS患者1年预后不良的列线图预测模型。结果:多因素Logistic回归分析显示,年龄(OR=1.069,95%CI 1.052~1.087,P=0.000)、合并肺炎(OR=3.121,95%CI 1.595~6.107,P=0.001)、白细胞计数(OR=1.137,95%CI 1.062~1.217,P=0.000)、心房颤动(OR=1.816,95%CI 1.059~3.115,P=0.030)、入院NIHSS评分(OR=1.196,95%CI 1.153~1.241,P=0.000)是西安地区AIS患者随访1年发生预后不良的独立危险因素。根据上述危险因素,成功建立预测AIS患者1年发生预后不良的列线图预测模型。该模型ROC曲线下面积(AUC)为0.846,具有良好的区分度;Hosmer-Lemeshow拟合优度检验结果显示差异无统计学意义(χ^(2)=12.22,df=8,P=0.142)。结论:成功建立用于预测AIS患者随访1年预后不良的列线图风险预测模型,该模型具有良好区分度与校准度。
Objective:To investigate the risk factors of poor prognosis 1 year after acute ischemic stroke(AIS)and to establish a nomogram risk prediction model.Methods:Clinical data of AIS patients who were consecutively admitted to 4 tertiary-grade A class hospitals from January to December 2015 were collected through the Xi’an Stroke Data Bank.The patients were followed up for 1 year after diagnosis.Univariate and multivariate Logistic analysis were applied to analyze the risk factors of poor 1-year prognosis.R software and the rms package were used to establish a nomogram risk prediction model for poor 1-year prognosis in AIS patients.Results:Multivariate Logistic regression analysis showed that age(OR=1.069,95%CI 1.052~1.087,P=0.000),complication by pneumonia(OR=3.121,95%CI 1.595~6.107,P=0.001),leukocyte count(OR=1.137,95%CI 1.062~1.217,P=0.000),atrial fibrillation(OR=1.816,95%CI 1.059~3.115,P=0.030),and NIHSS score at admission(OR=1.196,95%CI 1.153~1.241,P=0.000)were independent risk factors for poor 1-year prognosis of AIS patients in the Xi’an area.Based on the above independent risk factors,a nomogram prediction model was established to predict poor 1-year prognosis in AIS patients.ROC curve analysis showed that the area under the curve(AUC)was 0.846,indicating good discrimination.The Hosmer-Lemeshow test showed no significant difference(χ^(2)=12.22,df=8,P=0.142).Conclusion:A nomogram risk prediction model for poor 1-year prognosis in AIS patients was successfully established.This model has good differentiation and calibration.
作者
张娜
刘仲仲
逯青丽
王静
刘佩
刘燕
常乔乔
王燕
宋沉生
蔺雪梅
王芳
吴松笛
ZHANG Na;LIU Zhong-zhong;LU Qing-li;WANG Jing;LIU Pei;LIU Yan;CHANG Qiao-qiao;WANG Yan;SONG Chen-sheng;LIN Xue-mei;WANG Fang;WU Song-di(Department of Neurology,Xi’an No.1 Hospital,the First Affiliated Hospital of Northwest University,Xi’an 710002,China)
出处
《神经损伤与功能重建》
2022年第5期254-258,共5页
Neural Injury and Functional Reconstruction
基金
陕西省科技计划项目(No.2017SF-163,2021SF-333)
西安市科技计划重大项目[No.201805104YX12SF38(2)]
西安市科技计划项目[No.20YXYJ0008(1)]
西安市卫健委科研项目(No.2020ms03,2020yb05,2021yb33)。
