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诺模图模型的建立与验证以及心房颤动消融术后无症状性脑梗死的概率

Establishment and Validation of the Nomogram Model and the Probability of Silent Cerebral Infarction After Ablation Atrial Fibrillation.

作者信息

Bao Wei, Hu Xiaoqin, Ge Liqi, Tang Shiyun, Zhao Xinliang, Huang Shuo, Liu Chen, Li Fei, Zhang Chaoqun, Li Chengzong

机构信息

Department of Cardiology, The Affiliated Hospital of Xuzhou Medical University, Xuzhou, 221000, Jiangsu, China.

出版信息

Cardiovasc Drugs Ther. 2025 Apr;39(2):307-316. doi: 10.1007/s10557-023-07530-4. Epub 2023 Dec 16.

Abstract

BACKGROUND

The objective of this study is to establish and validate a nomogram model for predicting the probability of silent cerebral infarction following ablation of atrial fibrillation.

METHODS AND RESULTS

A retrospective observational study was conducted on the data of 238 patients with atrial fibrillation who underwent radiofrequency ablation in our hospital from October 2019 to December 2022. LASSO regression and multivariate logistics regression analysis were used to assess the independent risk factors for silent cerebral infarction after ablation. The AUC of the predictive model was 0.733 (95% CI, 0.649-0.816) and the internal validation (bootstrap = 1000) of the bootstrap method was 0.733 (95% CI 0.646-0.813). The Hosmer-Lemeshow test yields an insignificant p-value of X-squared = 10.212 and p-value = 0.2504, thus indicating an insignificant difference between predicted and observed values and good calibration results. The clinical impact curve (CIC) and clinical decision curve also prove that this graph is useful in the clinical setting.

CONCLUSION

We developed an easy-to-use nomogram model to predict the probability of silent cerebral infarction following radiofrequency ablation of atrial fibrillation. This model can provide a valid assessment of the probability of postoperative silent cerebral infarction in patients undergoing radiofrequency ablation of atrial fibrillation.

摘要

背景

本研究的目的是建立并验证一种列线图模型,用于预测心房颤动消融术后无症状性脑梗死的发生概率。

方法与结果

对2019年10月至2022年12月在我院接受射频消融的238例心房颤动患者的数据进行回顾性观察研究。采用LASSO回归和多因素logistic回归分析评估消融术后无症状性脑梗死的独立危险因素。预测模型的AUC为0.733(95%CI,0.649 - 0.816),自抽样法的内部验证(自抽样 = 1000)为0.733(95%CI 0.646 - 0.813)。Hosmer-Lemeshow检验得出X² = 10.212,p值 = 0.2504,差异无统计学意义,表明预测值与观察值之间差异无统计学意义,校准结果良好。临床影响曲线(CIC)和临床决策曲线也证明该图在临床环境中有用。

结论

我们开发了一种易于使用的列线图模型,以预测心房颤动射频消融术后无症状性脑梗死的发生概率。该模型可以对接受心房颤动射频消融术的患者术后无症状性脑梗死的概率提供有效的评估。

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