Zhu Zhao-Ying, Hao Li-Fang, Gao Li-Chuan, Li Xiao-Long, Zhao Jie-Yi, Zhang Tao, Zhang Gui-Jun, You Chao, Wang Xiao-Yu
Department of Neurosurgery, West China Hospital, Sichuan University, No. 37 Guo Xue Xiang, Chengdu, 610041, Sichuan, China.
Department of Radiology, Liaocheng The Third People's Hospital, Liaocheng, China.
Heliyon. 2023 Oct 6;9(10):e20781. doi: 10.1016/j.heliyon.2023.e20781. eCollection 2023 Oct.
Given that limited reports have described the survival and risk factors for elderly patients with hypertensive intracerebral hemorrhage (HICH), we aimed to develop a valid but simple prediction nomogram for the survival of HICH patients.
All elderly patients ≥65 years old who were diagnosed with HICH between January 2011 and December 2019 were identified. We performed the least absolute shrinkage and selection operator (Lasso) on the Cox regression model with the R package glmnet. A concordance index was performed to calculate the nomogram discrimination; and calibration curves and decision curves were graphically evaluated by depicting the observed rates against the probabilities predicted by the nomogram.
A total of 204 eligible patients were analyzed, and over 20 % of the population was above the age of 80 (65-79 years old, n = 161; 80+ years old, n = 43). A hematoma volume ≥13.64 cm3 was associated with higher 7-day mortality (OR = 6.773, 95 % CI = 2.622-19.481; p < 0.001) and higher 90-day mortality (OR = 3.955, 95 % CI = 1.611-10.090, p = 0.003). A GCS score between 13 and 15 at admission was associated with a 7-day favorable outcome (OR = 0.025, 95 % CI = 0.005-0.086; p < 0.001) and a 90-day favorable outcome (OR = 0.033, 95 % CI = 0.010-0.099; p < 0.001).
Our nomogram models were visualized and accurate. Neurosurgeons could use them to assess the prognostic factors and provide advice to patients and their relatives.
鉴于关于老年高血压性脑出血（HICH）患者生存率及危险因素的报道有限，我们旨在开发一种有效且简便的预测列线图，用于预测HICH患者的生存率。
确定了2011年1月至2019年12月期间诊断为HICH的所有≥65岁老年患者。我们使用R包glmnet在Cox回归模型上进行了最小绝对收缩和选择算子（Lasso）分析。通过计算一致性指数来评估列线图的辨别力；通过描绘观察到的发生率与列线图预测的概率，以图形方式评估校准曲线和决策曲线。
共分析了204例符合条件的患者，超过20%的人群年龄在80岁以上（65 - 79岁，n = 161；80岁及以上，n = 43）。血肿体积≥13.64 cm³与7天死亡率较高相关（OR = 6.773，95%CI = 2.622 - 19.481；p < 0.001）以及90天死亡率较高相关（OR = 3.955，95%CI = 1.611 - 10.090，p = 0.003）。入院时格拉斯哥昏迷量表（GCS）评分为13至15分与7天良好预后相关（OR = 0.025，95%CI = 0.005 - 0.086；p < 0.001）以及90天良好预后相关（OR = 0.033，95%CI = 0.010 - 0.099；p < 0.001）。
我们的列线图模型直观且准确。神经外科医生可使用它们来评估预后因素，并为患者及其亲属提供建议。
