基于全身炎症反应指数和临床危险因素的列线图预测高龄高血压脑出血患者短期预后

A nomogram based on systemic inflammation response index and clinical risk factors for prediction of short-term prognosis of very elderly patients with hypertensive intracerebral hemorrhage.

作者信息

Wang Shen, Wang Ruhai, Li Xianwang, Liu Xin, Lai Jianmei, Sun Hongtao, Hu Haicheng

机构信息

The First School of Clinical Medical, Lanzhou University, Lanzhou, China.

Tianjin Key Laboratory of Neurotrauma Repair, Characteristic Medical Center of People's Armed Police Forces, Tianjin, China.

出版信息

Front Med (Lausanne). 2025 Mar 28;12:1535443. doi: 10.3389/fmed.2025.1535443. eCollection 2025.

DOI:10.3389/fmed.2025.1535443

PMID:40224624

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11985803/

Abstract

OBJECTIVE

To develop and validate a nomogram based on systemic inflammation response index (SIRI) and clinical risk factors to predict short-term prognosis in very elderly patients with hypertensive intracerebral hemorrhage (HICH).

METHODS

A total of 324 very elderly HICH patients from January 2017 to June 2024 were retrospectively enrolled and randomly divided into two cohorts for training ( = 227) and validation ( = 97) according to the ratio of 7:3. Independent predictors of poor prognosis were analyzed using univariate and multivariate logistic regression analyses. Furthermore, a nomogram prediction model was built. The area under the receiver operating characteristic curves (AUC), calibration plots and decision curve analysis (DCA) were used to evaluate the performance of the nomogram in predicting the prognosis of very elderly HICH.

RESULTS

By univariate and stepwise multivariate logistic regression analyses, GCS score ( < 0.001), hematoma expansion ( = 0.049), chronic obstructive pulmonary disease ( = 0.010), and SIRI ( = 0.005) were independent predictors for the prognosis in very elderly patients with HICH. The nomogram showed the highest predictive efficiency in the training cohort (AUC = 0.940, 95% CI: 0.909 to 0.971) and the validation cohort (AUC = 0.884, 95% CI: 0.813 to 0.954). The calibration curve indicated that the nomogram had good calibration. DCA showed that the nomogram had high applicability in clinical practice.

CONCLUSION

The nomogram incorporated with the SIRI and clinical risk factors has good potential in predicting the short-term prognosis of very elderly HICH.

摘要

目的

基于全身炎症反应指数（SIRI）和临床危险因素开发并验证一种列线图，以预测高龄高血压性脑出血（HICH）患者的短期预后。

方法

回顾性纳入2017年1月至2024年6月期间的324例高龄HICH患者，并按照7:3的比例随机分为训练队列（n = 227）和验证队列（n = 97）。采用单因素和多因素逻辑回归分析来分析预后不良的独立预测因素。此外，构建了列线图预测模型。使用受试者操作特征曲线下面积（AUC）、校准图和决策曲线分析（DCA）来评估列线图预测高龄HICH患者预后的性能。

结果

通过单因素和逐步多因素逻辑回归分析，格拉斯哥昏迷量表（GCS）评分（P < 0.001）、血肿扩大（P = 0.049）、慢性阻塞性肺疾病（P = 0.010）和SIRI（P = 0.005）是高龄HICH患者预后的独立预测因素。列线图在训练队列（AUC = 0.940，95%CI：0.909至0.971）和验证队列（AUC = 0.884，95%CI：0.813至0.954）中显示出最高的预测效率。校准曲线表明列线图具有良好的校准性。DCA显示列线图在临床实践中具有较高的适用性。