Department of Emergency Medicine, The First Affiliated Hospital of Fujian Medical University, Fuzhou, China; Department of Emergency Medicine, National Regional Medical Center, Binhai Campus of the First Affiliated Hospital, Fujian Medical University, Fuzhou, China.
Department of Emergency Medicine, Quanzhou First Hospital Affiliated to Fujian Medical University, Quanzhou, China.
J Gastrointest Surg. 2024 Oct;28(10):1646-1653. doi: 10.1016/j.gassur.2024.07.025. Epub 2024 Jul 31.
This study aimed to create a nomogram using the model for end-stage liver disease (MELD) that can better predict the risk of 28-day mortality in patients with bleeding esophageal varices.
Data on patients with bleeding esophageal varices were retrospectively collected from the Medical Information Mart for Intensive Care database. Variables were selected using the least absolute shrinkage and selection operator logistic regression model and were used to construct a prognostic nomogram. The nomogram was evaluated against the MELD model using various methods, including receiver operating characteristic (ROC) curve analysis, calibration plotting, net reclassification improvement (NRI), integrated discrimination improvement (IDI), and decision curve analysis (DCA).
A total of 280 patients were included in the study. The patient's use of vasopressin and norepinephrine, respiratory rate, temperature, mean corpuscular volume, and MELD score were included in the nomogram. The area under the ROC curve, NRI, IDI, and DCA of the nomogram indicated that it performs better than the MELD alone.
A nomogram was created that outperformed the MELD score in forecasting the risk of 28-day mortality in individuals with bleeding esophageal varices.
本研究旨在创建一个基于终末期肝病模型（MELD）的列线图，以更好地预测出血性食管静脉曲张患者 28 天死亡率的风险。
从医疗信息集中监护数据库中回顾性地收集出血性食管静脉曲张患者的数据。使用最小绝对收缩和选择算子逻辑回归模型选择变量，并用于构建预后列线图。使用各种方法（包括接收者操作特征曲线分析、校准绘图、净重新分类改善、综合判别改善和决策曲线分析）评估列线图与 MELD 模型的比较。
共有 280 名患者纳入研究。该列线图包括患者使用血管加压素和去甲肾上腺素、呼吸频率、体温、平均红细胞体积和 MELD 评分。列线图的 ROC 曲线下面积、NRI、IDI 和 DCA 表明，其预测出血性食管静脉曲张患者 28 天死亡率的风险优于 MELD 单独预测。
创建了一个列线图，在预测出血性食管静脉曲张患者 28 天死亡率的风险方面优于 MELD 评分。
