摘要
目的分析胶质瘤患者术后并发静脉血栓栓塞(venous thromboembolism,VTE)的危险因素,并构建Nomogram模型。方法收集2018年9月~2023年4月徐州医科大学附属医院收治的401例胶质瘤患者的临床资料,采用单因素和多因素Logistic回归分析探讨胶质瘤发生VTE的危险因素。构建Nomogram模型后,采用受试者工作特征(receiver operating characteristic,ROC)曲线检验模型的鉴别效能,Calibration校准曲线评价模型的校准度,Hosmer-Lemeshow拟合优度检验模型的校准曲线,Bootstrap自抽样法对模型进行内部验证,决策曲线分析(decision curve analysis,DCA)评价其临床获益性。结果Logistic回归分析结果显示,年龄、体重指数、血小板、白细胞、D-二聚体、IDH表型为胶质瘤术后发生VTE的独立危险因素;Nomogram模型预测胶质瘤术后发生VTE的ROC曲线下面积为0.898;校准曲线、C指数和外部验证提示模型具有较高的准确性,DCA结果显示模型具有较好的临床有效性。结论本研究基于胶质瘤患者术后发生VTE的危险因素构建的预测模型,经内、外部验证后,显示诊断效能良好,能够为临床决策提供依据。
Objective To analyze the risk factors of postoperative complication of venous thromboembolism(VTE)in glioma patients,and to construct Nomogram model.Methods The clinical data of 40lglioma patients admitted to the Affiliated Hospital of Xuzhou Medical University from September 2018 to April 2023 were collected,and the risk factors of VTE in glioma were explored using univariate analysis and multivariate Logistic regression analysis.After constructing the Nomogram model,the discriminative efficacy of the model was examined using the receiver operating characteristic(ROC)curve,the calibration degree of the model was evaluated by calibration curve,the calibration curve was examined by the Hosmer-Lemeshow goodness-of-fit test,the model was internally validated using the Boot-strap selfsampling method,and the clinical benefit was analyzed by the decision curve analysis(DCA).Results Logistic regression a-nalysis showed that age,body mass index,platelets,leukocytes,Ddimer,and IDH phenotype were independent risk factors for the occurrence of VTE after glioma surgery;the Nomogram model predicted that the area under the ROC curve for the occurrence of VTE after glioma surgery was 0.898;the calibration curves,Cindex,and external validation suggested that the model had a high degree of accuracy,and the DCA showed that the model had good clinical validity.Conclusion The prediction model constructed based on the risk factors for postoperative VTE in glioma patients in this study was internally and externally validated,showing good diagnostic efficacy and providing a basis for clinical decision-making.
作者
邓李轶
章宇顺
王雷
张桐
徐义强
刘勇
DENG Liyi;ZHANG Yush-un;WANG Lei(Department of Neurosurgery,Affiliated Hospital of Xuzhou Medical University,Jiangsu 221000,China)
出处
《医学研究杂志》
2024年第7期51-56,共6页
Journal of Medical Research
基金
国家自然科学基金青年科学基金资助项目(82002632)
江苏省徐州市科技重点研发计划项目(KC20139)。
