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一种用于预测中国 2 型糖尿病患者带状疱疹感染风险的新型预测列线图的开发与评估

Development and Evaluation of a New Predictive Nomogram for Predicting Risk of Herpes Zoster Infection in a Chinese Population with Type 2 Diabetes Mellitus.

作者信息

Zeng Ni, Li Yueyue, Wang Qian, Chen Yihe, Zhang Yan, Zhang Lanfang, Jiang Feng, Yuan Wei, Luo Dan

机构信息

Department of Dermatology, Affiliated Hospital of Zunyi Medical University,149 Dalian Road, Huichuan District, Guizhou, 563003, People's Republic of China.

Department of Dermatology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, 210000, People's Republic of China.

出版信息

Risk Manag Healthc Policy. 2021 Nov 27;14:4789-4797. doi: 10.2147/RMHP.S310938. eCollection 2021.

Abstract

PURPOSE

To identify potential risk factors for herpes zoster infection in type 2 diabetes mellitus in southeast Chinese population.

PATIENTS AND METHODS

We built a model involving 266 herpes zoster patients collecting data from January 2018 to December 2019. The least absolute shrinkage and selection operator (Lasso) predictive model was used to test herpes zoster virus risk using the patient data. Multivariate regression was conducted to decide which variable would be the strongest to decrease the Lasso penalty. The predictive model was tested using the C-index, a calibration plot, and decision curve study. External validity was verified by bootstrapping by counting probabilities.

RESULTS

In the prediction nomogram, the prediction variables included age, sex, weight, length of hospital stay, infection, and blood pressure. The C-index of 0.844 (0.798-0.896) indicated substantial variability and thus the model was adjusted appropriately. A score of 0.825 was achieved somewhere in the above interval. Examination of the decision curve estimated that herpes zoster nomogram was useful when the intervention was determined at the 16 percent of the herpes zoster infection potential threshold.

CONCLUSION

The herpes zoster nomogram combines age, weight, position of the rash, 2-hour plasma glucose, glycosuria, serum creatinine, length of the hospital stay, and hypertension. This calculator can be used to assess the individual herpes zoster risks in patients diagnosed with type 2 diabetes mellitus.

摘要

目的

确定中国东南部2型糖尿病患者带状疱疹感染的潜在危险因素。

患者与方法

我们建立了一个包含266例带状疱疹患者的模型,收集了2018年1月至2019年12月的数据。使用最小绝对收缩和选择算子(Lasso)预测模型,利用患者数据测试带状疱疹病毒风险。进行多变量回归以确定哪个变量对降低Lasso惩罚作用最强。使用C指数、校准图和决策曲线研究对预测模型进行测试。通过计算概率的自助法验证外部有效性。

结果

在预测列线图中,预测变量包括年龄、性别、体重、住院时间、感染和血压。C指数为0.844(0.798 - 0.896),表明有显著差异,因此模型得到了适当调整。在上述区间内的某个位置获得了0.825的分数。决策曲线分析估计,当在带状疱疹感染潜在阈值的16%处确定干预措施时,带状疱疹列线图是有用的。

结论

带状疱疹列线图综合了年龄、体重、皮疹位置、2小时血糖、糖尿、血清肌酐、住院时间和高血压。该计算器可用于评估2型糖尿病确诊患者个体的带状疱疹风险。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/cb11/8636977/327ce1bd7af9/RMHP-14-4789-g0001.jpg

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