构建和验证一个预测模型,用于在腹膜透析导管注射后与腹膜透析相关的腹膜炎风险
Rong Dai1, Chuyi Peng2, Tian Sang2
1Department of Chinese Medicine, Anhui University of Chinese Medicine, Hefei, China.
Frontiers in medicine
|October 4, 2023
概括
一个新的模型使用中性粒细胞与淋巴细胞比率 (NLR),白蛋白 (ALB),尿酸 (UA),hsCRP和糖尿病 (DM) 来预测腹膜透析相关的腹膜炎 (PDAP) 风险. 该工具有助于对腹膜透析患者的PDAP风险早期评估.
科学领域:
- 腎臟病學 (nephrology) 是一種醫學專業.
- 临床流行病学临床流行病学
- 医疗信息学 医疗信息学
背景情况:
- 腹膜透析相关的腹膜炎 (PDAP) 是患有腹膜透析 (PD) 患者的重大并发症.
- 准确的风险预测模型对于及时干预和改善PD治疗患者结果至关重要.
研究的目的:
- 开发和验证一种预测模型,用于识别患有PDAP的高风险患者.
- 确定主要的临床和实验室参数,作为PDAP的独立预测指标.
主要方法:
- 从2016年1月到2021年1月对PD患者的回顾性分析.
- 使用最小绝对收缩和选择操作员 (LASSO) 回归来进行变量选择.
- 开发并验证了使用多因素逻辑回归,ROC曲线,校准曲线,Hosmer-Lemeshow测试和决策曲线分析 (DCA) 的预测模型.
主要成果:
- 确定了PDAP的五个独立预测因素:中性粒细胞与淋巴细胞的比率 (NLR),血清白蛋白 (ALB),尿酸 (UA),高灵敏度C反应蛋白 (hsCRP) 和糖尿病 (DM).
- 开发的预测模型显示出强大的区分能力,AUC值为0.891 (训练) 和0.882 (验证).
- 该模型显示了良好的校准和临床实用性,由Hosmer-Lemeshow测试和DCA证实.
结论:
- NLR,ALB,UA,hsCRP和DM是PD患者PDAP的显著独立预测因素.
- 构建的列直线图模型有效预测PDAP风险,为腹腔透析患者的管理提供有价值的临床决策支持.
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