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患有自发性腹腔积血的犬血管肉瘤可能性预测模型的开发与验证:HeLP评分

Development and validation of a hemangiosarcoma likelihood prediction model in dogs presenting with spontaneous hemoabdomen: The HeLP score.

作者信息

Schick Ashley R, Hayes Galina M, Singh Ameet, Mathews Kyle G, Higginbotham Mary Lynn, Sherwood J Matthew

机构信息

Cornell University College of Veterinary Medicine, Ithaca, New York.

Ontario Veterinary College, University of Guelph, Guelph, Ontario, Canada.

出版信息

J Vet Emerg Crit Care (San Antonio). 2019 May;29(3):239-245. doi: 10.1111/vec.12838. Epub 2019 Apr 17.

Abstract

OBJECTIVE

To calculate a risk prediction model for hemangiosarcoma (HSA) diagnosis in dogs presenting with nontraumatic hemoabdomen.

DESIGN

Retrospective multicenter observational cohort study enrolling dogs presented 2003-2016.

SETTING

Five academic veterinary medical centers.

ANIMALS

A total of 406 dogs with nontraumatic hemoabdomen as the presenting complaint that underwent surgical exploration or necropsy and received a histological diagnosis. Overall, 219 dogs from 3 centers provided the data for model construction, and 187 dogs from 2 centers provided the population for external validation.

INTERVENTIONS

None.

MEASUREMENTS AND MAIN RESULTS

The risk score was modeled on 4 predictors: bodyweight (P = 0.01), total plasma protein (P < 0.01), platelet count (P < 0.01), and thoracic radiograph findings (P = 0.02). The incidence of HSA diagnosis was 36%, 76%, and 96% in the low risk (≤40), medium risk (41-55), and high risk (>55) score groups, respectively. The risk score AUROC was 0.85 (95% CI 0.79-0.90) on the construction population, and 0.77 (95% CI 0.70-0.84) on the validation population.

CONCLUSIONS

The risk of HSA diagnosis in dogs presenting with nontraumatic hemoabdomen could be predicted using a simple risk score, which could aid in identification and treatment of dogs at lower risk for this diagnosis.

摘要

目的

计算非创伤性腹腔积血犬血管肉瘤(HSA)诊断的风险预测模型。

设计

2003年至2016年纳入犬只的回顾性多中心观察队列研究。

地点

五个学术性兽医医学中心。

动物

共有406只以非创伤性腹腔积血为主诉的犬只接受了手术探查或尸检,并获得了组织学诊断。总体而言,来自3个中心的219只犬提供了模型构建数据,来自2个中心的187只犬提供了外部验证的总体。

干预措施

无。

测量和主要结果

风险评分基于4个预测因素建模:体重(P = 0.01)、总血浆蛋白(P < 0.01)、血小板计数(P < 0.01)和胸部X光片检查结果(P = 0.02)。低风险(≤40)、中风险(41 - 55)和高风险(>55)评分组的HSA诊断发生率分别为36%、76%和96%。构建总体的风险评分受试者工作特征曲线下面积(AUROC)为0.85(95%置信区间0.79 - 0.90),验证总体的为0.77(95%置信区间0.70 - 0.84)。

结论

使用简单的风险评分可以预测非创伤性腹腔积血犬的HSA诊断风险,这有助于识别和治疗该诊断风险较低的犬只。

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