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原发性脑桥出血患者预后因素临床预测模型的开发与验证

Development and validation of a clinical prediction model for prognostic factors in patients with primary pontine hemorrhage.

作者信息

Hu Anquan, Qin Heyan, Wu Shina, Zhao Xiaolin, Li Yumeng, Chen Feng, Liu Tao

机构信息

Department of Geriatric Center, Hainan General Hospital (Hainan Affiliated Hospital of Hainan Medical University), Haikou, China.

Department of Neurology, Hainan General Hospital (Hainan Affiliated Hospital of Hainan Medical University), Haikou, China.

出版信息

Braz J Med Biol Res. 2024 Apr 19;57:e13359. doi: 10.1590/1414-431X2024e13359. eCollection 2024.

Abstract

We aimed to develop a prognostic model for primary pontine hemorrhage (PPH) patients and validate the predictive value of the model for a good prognosis at 90 days. A total of 254 PPH patients were included for screening of the independent predictors of prognosis, and data were analyzed by univariate and multivariable logistic regression tests. The cases were then divided into training cohort (n=219) and validation cohort (n=35) based on the two centers. A nomogram was developed using independent predictors from the training cohort to predict the 90-day good outcome and was validated from the validation cohort. Glasgow Coma Scale score, normalized pixels (used to describe bleeding volume), and mechanical ventilation were significant predictors of a good outcome of PPH at 90 days in the training cohort (all P<0.05). The U test showed no statistical difference (P=0.892) between the training cohort and the validation cohort, suggesting the model fitted well. The new model showed good discrimination (area under the curve=0.833). The decision curve analysis of the nomogram of the training cohort indicated a great net benefit. The PPH nomogram comprising the Glasgow Coma Scale score, normalized pixels, and mechanical ventilation may facilitate predicting a 90-day good outcome.

摘要

我们旨在为原发性脑桥出血(PPH)患者开发一种预后模型,并验证该模型对90天良好预后的预测价值。共纳入254例PPH患者以筛选预后的独立预测因素,并通过单因素和多因素逻辑回归检验分析数据。然后根据两个中心将病例分为训练队列(n = 219)和验证队列(n = 35)。使用来自训练队列的独立预测因素制定了列线图,以预测90天的良好结局,并在验证队列中进行了验证。格拉斯哥昏迷量表评分、标准化像素(用于描述出血量)和机械通气是训练队列中PPH患者90天良好结局的显著预测因素(均P<0.05)。U检验显示训练队列和验证队列之间无统计学差异(P = 0.892),表明模型拟合良好。新模型显示出良好的区分度(曲线下面积 = 0.833)。训练队列列线图的决策曲线分析显示出较大的净效益。包含格拉斯哥昏迷量表评分、标准化像素和机械通气的PPH列线图可能有助于预测90天的良好结局。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7685/11027180/7127dcda56af/1414-431X-bjmbr-57-e13359-gf001.jpg

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