在竞争风险下的多变体关节模型,预测住院患者因SARS-CoV-2感染而死亡
Alexandra Lavalley-Morelle1, Nathan Peiffer-Smadja1,2, Simon B Gressens2
1Université Paris Cité, INSERM, IAME, Paris, France.
Biometrical journal. Biometrische Zeitschrift
|November 2, 2023
概括
这项研究表明,使用纵向患者数据,包括血液中性粒细胞计数,动脉pH值和C反应蛋白,可以改善COVID-19患者的预测结果. 与仅使用入院数据的模型相比,联合建模方法提高了预测准确性.
科学领域:
- 生物统计学 生物统计学
- 流行病学 流行病学
- 临床医学 临床医学
背景情况:
- 现有的COVID-19预后得分依赖于入院数据.
- 纵向患者数据可能会提高预测准确度.
- 准确的预测对于管理住院COVID-19患者至关重要.
研究的目的:
- 评估纵向生物标志物数据是否可以改善COVID-19患者的预测结果.
- 开发和验证用于预测死亡或出院的联合建模方法.
主要方法:
- 对327名住院COVID-19患者的分析.
- 纵向测量多达59个生物标志物.
- 利用一种联合模型,将生物标志物演变的混合效应模型和生存结果的竞争风险模型结合起来.
主要成果:
- 确定了三个关键生物标志物:血液中性粒细胞计数,动脉pH值和C反应蛋白.
- 联合模型显著提高了预测准确性 (AUC为0.81比0.73在30天,p=0.04).
- 模型性能通过模拟研究来验证.
结论:
- 结合纵向生物标志物数据的联合建模增强了对COVID-19患者结果的预测.
- 这种方法比仅使用基线信息的模型提供了更好的预测准确性.
- 已识别的生物标志物对于预测住院COVID-19患者的临床轨迹非常有价值.
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