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建立一个预测 ICU 收治乳腺癌患者死亡率的模型。

Development of a model for predicting mortality of breast cancer admitted to Intensive Care Unit.

机构信息

Department of head, neck and breast surgery, Yue Bei People's Hospital, Shaoguan, China.

Department of ophthalmology, Yue Bei People's Hospital, Shaoguan, China.

出版信息

Afr Health Sci. 2022 Sep;22(3):155-165. doi: 10.4314/ahs.v22i3.18.

Abstract

BACKGROUND

There is still not a mortality prediction model built for breast cancer admitted to intensive care unit (ICU).

OBJECTIVES

We aimed to build a prognostic model with comprehensive data achieved from eICU database.

METHODS

Outcome was defined as all-cause in-hospital mortality. Least absolute shrinkage and selection operator (LASSO) was conducted to select important variables which were then taken into logistic regression to build the model. Bootstrap method was then conducted for internal validation.

RESULTS

448 patients were included in this study and 79 (17.6%) died in hospital. Only 5 items were included in the model and the area under the curve (AUC) was 0.844 (95% confidence interval [CI]: 0.804-0.884). Calibration curve and Brier score (0.111, 95% CI: 0.090-0.127) showed good calibration of the model. After internal validation, corrected AUC and Brier score were 0.834 and 0.116. Decision curve analysis (DCA) also showed effective clinical use of the model. The model can be easily assessed on website of https://breastcancer123.shinyapps.io/BreastCancerICU/.

CONCLUSIONS

The model derived in this study can provide an accurate prognosis for breast cancer admitted to ICU easily, which can help better clinical management.

摘要

背景

目前仍没有针对入住重症监护病房(ICU)的乳腺癌患者的死亡率预测模型。

目的

我们旨在利用 eICU 数据库中的综合数据建立一个预后模型。

方法

结局定义为全因院内死亡率。采用最小绝对值收缩和选择算子(LASSO)选择重要变量,然后将其纳入逻辑回归模型中建立模型。采用自举法进行内部验证。

结果

本研究纳入 448 例患者,其中 79 例(17.6%)患者在院死亡。该模型仅包含 5 项指标,曲线下面积(AUC)为 0.844(95%置信区间:0.804-0.884)。校准曲线和 Brier 评分(0.111,95%置信区间:0.090-0.127)表明模型具有良好的校准度。内部验证后,校正 AUC 和 Brier 评分分别为 0.834 和 0.116。决策曲线分析(DCA)也表明该模型具有有效的临床应用价值。该模型可在 https://breastcancer123.shinyapps.io/BreastCancerICU/ 网站上进行评估。

结论

本研究建立的模型可方便地为入住 ICU 的乳腺癌患者提供准确的预后评估,有助于更好的临床管理。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/21d3/9993303/a27e92c13e2a/AFHS2203-0155Fig1.jpg

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