摘要
目的构建并验证预测并发误吸的风险列线图模型。方法选取2021年4月至2023年4月该院收治的55例并发误吸卒中患者(误吸组)和55例未发生误吸卒中患者(对照组)作为研究对象。收集两组患者临床资料,使用单因素分析、多因素logistic回归模型分析卒中并发误吸的危险因素,利用R3、5、3软件基于筛选出的危险因素,构建卒中并发误吸风险的列线图模型,并验证此模型预测卒中并发误吸的效能。结果误吸组患者年龄(≥60岁)、梗死部位(脑干)、病灶部位(多发)、高血压构成比,以及美国国立卫生研究院卒中量表(NIHSS)评分和同型半胱氨酸(Hcy)、超敏C反应蛋白(hs-CRP)水平均高于对照组,差异有统计学意义(P<0.05)。多因素logistic回归分析结果显示,年龄(≥60岁)、梗死部位(脑干)、病灶部位(多发)、高血压及NIHSS评分(高)是影响卒中患者并发误吸的危险因素(P<0.05)。列线图模型结果显示,NIHSS评分是影响卒中患者并发误吸的最强预测因子,其次为年龄(≥60岁)、梗死部位(脑干)、病灶部位(多发)、高血压。模型验证结果显示,列线图受试者工作特征(ROC)曲线的曲线下面积为0.885(95%CI:0.701~0.945),一致性指数为0.831;H-L拟合优度检验结果显示,预测值与实际观测值之间差异无统计学意义(χ^(2)=4.112,P=0.459),表明该模型预测精准度和区分度良好。结论年龄(≥60岁)、梗死部位(脑干)、病灶部位(多发)、高血压、NIHSS评分(高)是影响卒中患者并发误吸的危险因素,列线图模型能有效预测卒中并发误吸的风险。
Objective To construct and validate a nomogram risk model for predicting concurrent aspiration.Methods Fifty-five stroke patients with aspiration(the aspiration group)and 55 patients without aspiration(the control group)admitted to this hospital from April 2021 to April 2023 were selected as the study objects.Clinical data of the two groups of patients were collected,univariate and multivariate logistic regression were used to analyze the risk factors of stroke with aspiration,and R software was used to construct a nomogram risk model of stroke with aspiration based on the screened risk factors,and the accuracy of this model in predicting stroke complicated aspiration was validated.Results Age(≥60 years),infarct site(brain stem),lesion site(multiple),hypertension component ratio,NIHSS score and Hcy and hs-CRP levels in the aspiration group were higher than those in the control group,with statistical significance(P<0.05).Multivariate logistic regression analysis showed that age(≥60 years old),infarct site(brainstem),lesion site(multiple),hypertension and NIHSS score(high)were the risk factors affecting aspiration in stroke patients(P<0.05).The results of the nomogram model showed that NIHSS score was the strongest predictor of aspiration in stroke patients,followed by age(≥60 years old),infarct site(brain stem),lesion site(multiple),and hypertension.Model validation results showed that the area under the curve of receiver operating characteristic(ROC)curve of the nomogram was 0.885(95%CI:0.701-0.945),and the consistency index was 0.831.HL goodness of fit test showed that there was no significant difference between the predicted value and the actual observed value(χ^(2)=4.112,P=0.459),indicating that the prediction accuracy and differentiation of the model were good.Conclusion Age(≥60 years old),infarct site(brainstem),lesion site(multiple),hypertension,NIHSS score(high),Hcy(high)and hs-CRP(high)were the risk factors affecting aspiration in stroke pa-tients.The nomogram model could effectively predict the risk of aspiration in stroke patients.
作者
徐金娟
吴丽萍
XU Jinjuan;WU Liping(Department of General Practice and Geriatric,Hangzhou Linping District Hospital of Integrated Traditional Chinese and Western Medicine,Hangzhou,Zhejiang 311100,China)
出处
《重庆医学》
CAS
2023年第23期3638-3642,3647,共6页
Chongqing medicine
关键词
卒中
并发症
误吸
列线图模型
stroke
complications
aspiration
nomogram model
