用于预测在接受里瓦罗克萨班治疗的患者中出现严重胃肠道出血的诺莫грам
Haiyan Cao1, Hongyan Xu2, Min Zhu2
1Department of Gastroenterology, Chengdu Second People's Hospital, Chengdu, People's Republic of China.
Scandinavian journal of gastroenterology
|June 15, 2023
概括
一个新的诺莫格拉姆模型准确地预测了在服用直接口服抗凝剂里瓦罗克萨班的患者中主要胃肠道出血 (MGIB) 的风险. 该工具有助于识别高风险个体,以更好地管理抗凝剂引起的出血.
科学领域:
- 药理学和胃肠病学 药理学和胃肠病学
- 临床风险预测建模模型
背景情况:
- 利瓦罗克萨班是一种直接口服抗凝剂,与严重胃肠道出血 (MGIB) 的高风险有关.
- 目前的临床实践缺乏有效的工具来识别风险较高的患者里瓦洛克萨班诱导MGIB.
研究的目的:
- 开发和验证一种名谱模型,用于预测处方里瓦洛克萨班的患者MGIB的风险.
主要方法:
- 356名接受里瓦洛克萨班治疗的患者的回顾性分析,其中178人被诊断患有MGIB.
- 后勤回归确定了MGIB的独立预测因素.
- 使用ROC曲线,Brier分数和校准图表构建并验证了一个名图.
主要成果:
- 关键的MGIB预测因素包括年龄,血红蛋白,血小板计数,肌,先前的胃潰瘍疾病,先前的出血,先前的中风,质子抑制剂的使用和抗血小板剂的使用.
- 命名图实现了0.833的曲线下的面积,表明了良好的区别.
- 内部验证表明可接受的准确性 (0.73) 和中等的协议 (kappa=0.46).
结论:
- 开发的诺米克图是一个有价值的工具,用于预测Rivaroxaban诱导的MGIB.
- 该模型表现出良好的区分,校准和临床适用性.
- 这个名图可以帮助临床医生识别高风险患者进行有针对性的干预.
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