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中文译文:中国人群起始腹膜透析患者心血管死亡风险预测模型的建立和验证:一项队列研究。

Development and validation of risk prediction models for cardiovascular mortality in Chinese people initialising peritoneal dialysis: a cohort study.

机构信息

Department of Nephrology, the First Affiliated Hospital, Zhengzhou University, Zhengzhou, 450052, China.

Arthritis Research UK Primary Care Centre, Research Institute for Primary Care & Health Sciences, Keele University, Keele, ST5 5BG, UK.

出版信息

Sci Rep. 2018 Jan 31;8(1):1966. doi: 10.1038/s41598-018-20160-3.

Abstract

Cardiovascular disease is the leading cause of death among patients receiving peritoneal dialysis. We aimed to develop and validate a risk prediction model for cardiovascular death within 2 years after the initiation of peritoneal dialysis (PD). A cohort including all patients registered with the Henan Peritoneal Dialysis Registry (HPDR) between 2007 and 2014. Multivariate logistic regression analysis was used to develop the risk prediction model. The HPDR data was randomly divided into two cohorts with 60% (1,835 patients) for model derivation, and 40% (1,219 patients) for model validation. The absolute rate of cardiovascular mortality was 14.2% and 14.4 in the derivation and validation cohort, respectively. Age, body mass index, blood pressure, serum lipids, fasting glucose, sodium, albumin, total protein, and phosphorus were the strongest predictors of cardiovascular mortality in the final model. Discrimination of the model was similar in both cohorts, with a C statistic above 0.70, with good calibration of observed and predicted risks. The new prediction model that has been developed and validated with clinical measurements that are available at the point of initiation of PD and could serve as a tool to screen for patients at high risk of cardiovascular death and tailor more intensive cardio-protective care.

摘要

心血管疾病是腹膜透析患者死亡的主要原因。我们旨在开发和验证腹膜透析(PD)开始后 2 年内心血管死亡的风险预测模型。该队列包括 2007 年至 2014 年间在河南腹膜透析登记处(HPDR)登记的所有患者。多变量逻辑回归分析用于开发风险预测模型。HPDR 数据随机分为两个队列,其中 60%(1835 例)用于模型推导,40%(1219 例)用于模型验证。推导队列和验证队列的心血管死亡率的绝对发生率分别为 14.2%和 14.4%。年龄、体重指数、血压、血脂、空腹血糖、钠、白蛋白、总蛋白和磷是最终模型中心血管死亡率的最强预测因素。该模型在两个队列中的区分度相似,C 统计量均高于 0.70,且观察到的和预测的风险具有良好的校准度。该新预测模型是使用 PD 起始时可获得的临床测量值开发和验证的,可以作为筛选心血管死亡风险高的患者的工具,并提供更强化的心脏保护护理。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/300f/5792639/4d2ec2d60e6f/41598_2018_20160_Fig1_HTML.jpg

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