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发热性惊厥预测模型的建立与验证。

Development and validation of a predictive model for febrile seizures.

机构信息

Department of Emergency, Shanghai Children's Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China.

出版信息

Sci Rep. 2023 Oct 31;13(1):18779. doi: 10.1038/s41598-023-45911-9.

Abstract

Febrile seizures (FS) are the most prevalent type of seizures in children. Existing predictive models for FS exhibit limited predictive ability. To build a better-performing predictive model, a retrospective analysis study was conducted on febrile children who visited the Children's Hospital of Shanghai from July 2020 to March 2021. These children were divided into training set (n = 1453), internal validation set (n = 623) and external validation set (n = 778). The variables included demographic data and complete blood counts (CBCs). The least absolute shrinkage and selection operator (LASSO) method was used to select the predictors of FS. Multivariate logistic regression analysis was used to develop a predictive model. The coefficients derived from the multivariate logistic regression were used to construct a nomogram that predicts the probability of FS. The calibration plot, area under the receiver operating characteristic curve (AUC), and decision curve analysis (DCA) were used to evaluate model performance. Results showed that the AUC of the predictive model in the training set was 0.884 (95% CI 0.861 to 0.908, p < 0.001) and C-statistic of the nomogram was 0.884. The AUC of internal validation set was 0.883 (95% CI 0.844 to 0.922, p < 0.001), and the AUC of external validation set was 0.858 (95% CI 0.820 to 0.896, p < 0.001). In conclusion, the FS predictive model constructed based on CBCs in this study exhibits good predictive ability and has clinical application value.

摘要

热性惊厥(FS)是儿童中最常见的惊厥类型。现有的 FS 预测模型的预测能力有限。为了构建性能更好的预测模型,对 2020 年 7 月至 2021 年 3 月期间在上海儿童医学中心就诊的热性儿童进行了回顾性分析研究。这些儿童被分为训练集(n=1453)、内部验证集(n=623)和外部验证集(n=778)。变量包括人口统计学数据和全血细胞计数(CBC)。采用最小绝对收缩和选择算子(LASSO)方法选择 FS 的预测因子。采用多变量逻辑回归分析建立预测模型。从多变量逻辑回归中得出的系数用于构建预测 FS 概率的列线图。校准图、受试者工作特征曲线下面积(AUC)和决策曲线分析(DCA)用于评估模型性能。结果显示,训练集中预测模型的 AUC 为 0.884(95%CI 0.861 至 0.908,p<0.001),列线图的 C 统计量为 0.884。内部验证集的 AUC 为 0.883(95%CI 0.844 至 0.922,p<0.001),外部验证集的 AUC 为 0.858(95%CI 0.820 至 0.896,p<0.001)。总之,本研究基于 CBC 构建的 FS 预测模型具有良好的预测能力,具有临床应用价值。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4c11/10618474/f3d7c30388e9/41598_2023_45911_Fig1_HTML.jpg

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