Xu Jiake, Wang Xing, Chen Wei, Tian Meng, You Chao
Department of Neurosurgery, Neurosurgery Research Laboratory, West China Hospital, Sichuan University, Chengdu, Sichuan, China.
West China Brain Research Centre, West China Hospital, Sichuan University, Chengdu, Sichuan, China.
Front Neurol. 2024 Oct 10;15:1464216. doi: 10.3389/fneur.2024.1464216. eCollection 2024.
Predicting long-term survival in intensive care unit patients with intracerebral hemorrhage (ICH) is crucial. This study aimed to develop a platelet-to-white blood cell ratio (PWR) incorporated nomogram for long-term survival prediction.
A retrospective analysis was conducted on 1,728 ICH patients in the MIMIC-IV 2.2 database. The independent prognostic value of PWR for 1-year mortality was assessed. A nomogram was developed using LASSO and Cox regression to predict 1-year survival, incorporating PWR and other factors. The performance of the nomogram was evaluated through calibration curves, area under the curve, Delong test, net reclassification index, integrated discrimination improvement, and decision curve analysis.
The nomogram, which included age, weight, Glasgow Coma Scale (GCS) score, mechanical ventilation, glucose, red blood cell (RBC) count, blood urea nitrogen (BUN), and PWR, showed good predictive performance for 1-year survival. The C-index was 0.736 (95% CI = 0.716-0.756) for the training set and 0.766 (95% CI = 0.735-0.797) for the testing set. Higher age and ventilation increased mortality risk, while higher weight, GCS score, RBC count, and PWR decreased risk. The nomogram outperformed conventional scores.
A nomogram incorporating PWR as a prognostic factor accurately predicts long-term survival in ICH patients. However, validation in large-scale multicenter studies and further exploration of biomarkers are needed.
预测重症监护病房脑出血（ICH）患者的长期生存率至关重要。本研究旨在开发一种纳入血小板与白细胞比值（PWR）的列线图，用于长期生存预测。
对MIMIC-IV 2.2数据库中的1728例ICH患者进行回顾性分析。评估PWR对1年死亡率的独立预后价值。使用LASSO和Cox回归开发列线图，以预测1年生存率，纳入PWR和其他因素。通过校准曲线、曲线下面积、德龙检验、净重新分类指数、综合判别改善和决策曲线分析评估列线图的性能。
该列线图包括年龄、体重、格拉斯哥昏迷量表（GCS）评分、机械通气、血糖、红细胞（RBC）计数、血尿素氮（BUN）和PWR，对1年生存率显示出良好的预测性能。训练集的C指数为0.736（95%CI = 0.716 - 0.756），测试集的C指数为0.766（95%CI = 0.735 - 0.797）。年龄较大和通气增加死亡风险，而体重较高、GCS评分较高、RBC计数较高和PWR降低风险。该列线图优于传统评分。
将PWR作为预后因素纳入的列线图可准确预测ICH患者的长期生存率。然而，需要在大规模多中心研究中进行验证并进一步探索生物标志物。
