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An Experimental Paradigm for the Prediction of Post-Operative Pain (PPOP)
Published on: January 27, 2010
Development and Validation of a Novel Clinical Prediction Model for Postherpetic Neuralgia: Integrating Inflammatory
YanPi Li1, NaiChong Hu1, Bifa Fan2
1Beijing University of Chinese Medicine, Beijing, 100029, People's Republic of China.
Background:
Postherpetic neuralgia (PHN) is the most common and debilitating complication of herpes zoster, yet predicting PHN occuring remains challenging.
Objectives:
Our study aimed to develop and validate a clinical prediction model for PHN based on key demographic, serological, and clinical parameters.
Study Design:
Retrospective cohort study.
Setting:
This study included 202 patients with herpes zoster treated at the China-Japan Friendship Hospital from December 2023 through November 2024.
Methods:
Eligible patients were classified into PHN (n = 89) and non-PHN (n = 113) groups. Clinical and laboratory data were extracted from electronic medical records. Univariate logistic regression (P < 0.20) identified candidate predictors, which were further refined using least absolute shrinkage and selection operator regression. A multivariate logistic regression model was constructed, and a predictive nomogram was developed. Model performance was evaluated using the area under the receiver operating characteristic curve (AUC), calibration plots, and decision curve analysis.
Results:
Four independent predictors were identified: age ≥ 60 years (odds ratio [OR] = 8.45; 95% CI. 3.94-18.12; P < 0.001), higher pain intensity measured by the Numeric Rating Scale (OR = 1.31; 95% CI, 1.07-1.61; P = 0.009), elevated D-dimer levels (D-dimer > 0.5 mg/L) (OR = 2.19; 95% CI, 1.10-4.36; P = 0.026), and lower neutrophil-to-lymphocyte ratio (≤ 3) (OR = 0.22; 95% CI, 0.10-0.49; P < 0.001). The final model demonstrated robust predictive accuracy (AUC = 0.83; 95% CI, 0.78-0.89) and good calibration (Hosmer-Lemeshow test, P = 0.326). A decision curve analysis confirmed the model's clinical utility within a risk threshold range of 8%-85%.
Limitations:
Our study is limited by its single-center design and small sample size.
Conclusion:
Our study developed a reliable and clinically applicable nomogram for PHN prediction in patients with herpes zoster. The model incorporates age, pain intensity, D-dimer level, and neutrophil-to-lymphocyte ratio,, enabling early risk stratification and optimized patient management. Future prospective studies are warranted to validate this model's utility across diverse populations.
