摘要
目的分析年龄相关性白内障患者术后并发干眼的危险因素,并构建列线图模型对其风险进行预测。方法收集2020年11月至2021年7月于我院行手术治疗的346例年龄相关性白内障患者临床资料。通过ROC曲线分析连续性变量的最佳截断值;多因素Logistic回归模型分析年龄相关性白内障患者术后并发干眼的危险因素并构建列线图模型,校正曲线对列线图模型进行内部验证,决策曲线评估列线图模型的预测效能。结果干眼组患者年龄、合并糖尿病比例、眼部过敏史比例、翼状胬肉比例、术中光照时间、3.0 mm切口比例均高于非干眼组。ROC曲线分析显示:年龄、术中光照时间的AUC分别为0.762、0.810;最佳截断值分别为59岁、39 min。年龄>59岁、合并糖尿病(是)、眼部过敏史(有)、翼状胬肉(有)、术中光照时间(>39 min)、切口大小(3.0 mm)是年龄相关性白内障患者术后并发干眼的独立危险因素。内部验证结果显示,列线图模型预测年龄相关性白内障患者术后并发干眼的C-index为0.726(95%CI:0.573~0.904),观测值与预测值之间保持较好一致性。列线图模型预测年龄相关性白内障患者术后并发干眼的阈值>0.16,列线图模型提供临床净收益,且均高于翼状胬肉、年龄、眼部过敏史、合并糖尿病、术中光照时间、切口大小。结论本研究基于年龄、合并糖尿病、眼部过敏史、翼状胬肉、术中光照时间、切口大小,构建了预测年龄相关性白内障患者术后并发干眼的列线图模型,该模型可提高预测年龄相关性白内障患者术后干眼的发生。
Objective To analyze the risk factors of postoperative dry eye in age related cataract patients,and to construct a nomogram model to predict the risk.Methods A retrospective case-control study.346 patients with senile cataract who underwent surgical treatment in our hospital from November 2020 to July 2021 were collected.Optimal cutoff values for statistically significant continuous variables were obtained by receiver operating characteristic(ROC)curve analysis.Multivariate Logistic regression model was used to analyze the risk factors of postoperative dry eye in patients with senile cataract.A nomogram model for predicting postoperative dry eye in age related cataract patients was constructed,and the calibration curve was used to conduct internal validation and performance evaluation of the nomogram model.Results The age,the proportion of diabetes and ocular allergy history and pterygium,the time of intraoperative illumination and the proportion of 3.0 mm incision in the dry eye group were higher than those in the non-dry eye group.ROC curve analysis showed that the area under the curve(AUC)of age and intraoperative light time were 0.762 and 0.81,respectively.The optimal cut-off values were 59 years and 39 minutes,respectively.Age>59 years old,diabetes mellitus(yes),eye allergy history(yes),pterygium(yes),intraoperative light time(>39 min),incision size(3.0 mm)were postoperative complications of senile cataract patients.Independent risk factors for dry eye.Internal validation results showed that the C-index of the nomogram model for predicting postoperative dry eye in patients with age related cataract was 0.726(95%confidence interval(CI):0.573-0.904).The calibration curve showed good agreement between the observed and predicted values.The threshold value of the nomogram model for predicting postoperative dry eye in patients with age related cataract was greater than 0.16,and the nomogram model provides a clinical net benefit:meat,intraoperative light time,incision size.Conclusions Based on age,diabetes mellitus
作者
曾振培
黄晓燕
梁晓东
李雯婷
吴海燕
Zeng Zhenpei;Huang Xiaoyan;Liang Xiaodong;Li Wenting;Wu Haiyan(Department of ophthalmology,the Second Affiliated Hospital of Guangdong Medical University,Zhanjiang 524003,China)
出处
《临床眼科杂志》
2023年第4期346-350,共5页
Journal of Clinical Ophthalmology
关键词
年龄相关性白内障
术后并发症
干眼
列线图预测模型
Age related cataract
Postoperative complications
Dry eye
Nomogram prediction model
