摘要
目的:构建老年糖尿病视网膜病变患者衰弱风险预测模型。方法:便利抽取2022年3月—2023年3月在安徽省某三级专科眼科医院眼科确诊并接受治疗的485例老年糖尿病视网膜病变(Diabetic retinopathy,DR)患者,按7∶3比例,随机分为建模组和验证组。对建模组数据采用Logistic回归分析建立老年DR患者衰弱风险预测模型,并通过验证组进行内部验证。采用Hosmer-Lemeshow检验和受试者工作特征(Receiver operating characteristic curve,ROC)曲线评估模型的预测效果,并绘制列线图。结果:老年DR患者衰弱的独立危险因素是婚姻状态、居住状态、运动习惯、有无合并其他糖尿病并发症、糖尿病病程、应对方式、孤独感得分等7个因素。风险预测模型Z=-2.646-1.358×婚姻状态(已婚)-1.208×居住状态(非独居)-0.980×运动习惯(有)+0.984×糖尿病病程+1.246×有无合并其他糖尿病并发症(有)+0.099×孤独感得分-0.581×应对方式(积极应对),预测概率为P=1/[1+exp(-Z)];模型Hosmer-Lemeshow检验结果显示,χ^(2)=11.838,P=0.156,最佳临界值为0.510,灵敏度为0.626,特异度为0.855,ROC曲线下面积为0.763,95%CI为0.711~0.814。内部验证结果显示,该模型灵敏度为0.766,特异度为0.741,正确率为86.21%。结论:本老年糖尿病视网膜病变患者衰弱风险预测模型具有良好的临床预测效果,可为医护人员评估老年糖尿病视网膜病变患者衰弱发生风险提供参考。
Objective:To construct a model for predicting frailty risk in elderly patients with diabetic retinopathy.Methods:A total of 485 elderly diabetic retinopathy(DR)patients diagnosed and treated in a tertiary specialized eye hospital in Anhui Province from March 2022 to March 2023 were conveniently selected.They were randomly divided into modeling group and verification group according to a ratio of 7∶3.Logistic regression analysis was used to establish the frailty risk prediction model for elderly DR patients using the data of the modeling group,and internal verification was carried out through the verification group.Hosmer-Lemeshow test and subject operating characteristic curve were used to evaluate the prediction effect of the model,and a column graph was drawn.Results:The independent risk factors of frailty in elderly DR patients were seven factors:marital status,residential status,exercise habits,whether there are other complications of diabetes,diabetes course,coping style,and loneliness score.Risk prediction model Z=-2.646-1.358×marital status(currently married)-1.208×residential status(not living alone)-0.980×exercise habits(yes)+0.984×diabetes course+1.246×whether there are other diabetes complications(yes)+0.099×loneliness score-0.581×coping style(positive response),the prediction probability is P=1[/1+exp(-Z)].Hosmer-Lemeshow test results of the model showed χ^(2)=11.838,P=0.156,the optimal critical value was 0.510,the sensitivity was 0.626,the specificity was 0.855,the area under ROC curve was 0.763,and the 95%CI was 0.711-0.814.Internal verification results showed that the sensitivity and specificity of the model were 0.766,0.741,and accuracy was 76.19%.Conclusion:This model has good clinical efficacy in predicting frailty risk in elderly patients with diabetic retinopathy.It can provide reference for medical staff to evaluate the risk of frailty in elderly patients with diabetic retinopathy.
作者
董旭婷
汪啸虎
盛永红
王国平
谷婷
DONG Xu-ting;WANG Xiao-hu;SHENG Yong-hong;WANG Guo-ping;GU Ting(Department of Basic Nursing,Anhui College of Traditional Chinese Medicine;Ophthalmology,Department of Wuhu Eye Hospital,Wuhu,Anhui 241001)
出处
《赣南医学院学报》
2023年第12期1275-1281,共7页
JOURNAL OF GANNAN MEDICAL UNIVERSITY
基金
安徽省高等学校自然科学研究项目(2022AH052639)。
