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多因素模型预测颅脑外伤后的早期预后。

Prediction of early prognosis after traumatic brain injury by multifactor model.

机构信息

Department of Neurosurgery, the First Affiliated Hospital of Chongqing Medical University, Chongqing, China.

出版信息

CNS Neurosci Ther. 2022 Dec;28(12):2044-2052. doi: 10.1111/cns.13935. Epub 2022 Aug 26.

Abstract

AIMS

To design a model to predict the early prognosis of patients with traumatic brain injury (TBI) based on parameters that can be quickly obtained in emergency conditions from medical history, physical examination, and supplementary examinations.

METHODS

The medical records of TBI patients who were hospitalized in two medical institutions between June 2015 and June 2021 were collected and analyzed. Patients were divided into the training set, validation set, and testing set. The possible predictive indicators were screened after analyzing the data of patients in the training set. Then prediction models were found based on the possible predictive indicators in the training set. Data of patients in the validation set and the testing set was provided to validate the predictive values of the models.

RESULTS

Age, Glasgow coma scale score, Apolipoprotein E genotype, damage area, serum C-reactive protein, and interleukin-8 (IL-8) levels, and Marshall computed tomography score were found associated with early prognosis of TBI patients. The accuracy of the early prognosis prediction model (EPPM) was 80%, and the sensitivity and specificity of the EPPM were 78.8% and 80.8% in the training set. The accuracy of the EPPM was 79%, and the sensitivity and specificity of the EPPM were 66.7% and 86.2% in the validation set. The accuracy of the early EPPM was 69.1%, and the sensitivity and specificity of the EPPM were 67.9% and 77.8% in the testing set.

CONCLUSION

Prediction models integrating general information, clinical manifestations, and auxiliary examination results may provide a reliable and rapid method to evaluate and predict the early prognosis of TBI patients.

摘要

目的

设计一种基于病史、体格检查和辅助检查中可在紧急情况下快速获得的参数来预测创伤性脑损伤(TBI)患者早期预后的模型。

方法

收集并分析了 2015 年 6 月至 2021 年 6 月期间在两家医疗机构住院的 TBI 患者的病历。患者被分为训练集、验证集和测试集。在分析训练集中患者的数据后,筛选出可能的预测指标。然后基于训练集中的可能预测指标找到预测模型。提供验证集和测试集患者的数据以验证模型的预测值。

结果

年龄、格拉斯哥昏迷量表评分、载脂蛋白 E 基因型、损伤面积、血清 C 反应蛋白和白细胞介素 8(IL-8)水平以及马歇尔计算机断层扫描评分与 TBI 患者的早期预后相关。早期预后预测模型(EPPM)的准确率为 80%,在训练集中的敏感性和特异性分别为 78.8%和 80.8%。验证集中 EPPM 的准确率为 79%,敏感性和特异性分别为 66.7%和 86.2%。测试集中 EPPM 的准确率为 69.1%,敏感性和特异性分别为 67.9%和 77.8%。

结论

整合一般信息、临床表现和辅助检查结果的预测模型可能为评估和预测 TBI 患者的早期预后提供一种可靠和快速的方法。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f621/9627380/a910c94c33a0/CNS-28-2044-g002.jpg

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