风险因素分析和诺莫格拉姆预测模型构建NEC因肠道穿孔而复杂
Pei Huang1,2,3, Nandu Luo1,2,3, Xiaoqi Shi1,2,3
1Department of Pediatrics, Affiliated Hospital of Zunyi Medical University, Zunyi, China.
BMC pediatrics
|February 27, 2024
概括
血的便,延长的激活部分血栓形成时间 (APTT),血栓缩和低albuminemia是预测肠道穿孔的关键指标新生儿与死角性肠球炎 (NEC). 一个开发的诺莫格拉姆模型显示了高预测价值,用于识别处于风险中的NEC患者.
科学领域:
- 新生儿医学 新生儿医学
- 胃肠病学 胃肠病学
- 手术儿科手术小儿科
背景情况:
- 死性肠球炎 (NEC) 是新生儿严重的胃肠道疾病.
- 肠道穿孔是NEC的关键并发症,显著增加死亡率.
- 在NEC中准确预测肠道穿孔对于及时干预至关重要.
研究的目的:
- 确定诊断为NEC的新生儿肠道穿孔相关的临床特征.
- 开发和验证一个对NEC患者肠孔发生率的预测模型.
主要方法:
- 对180名患有NEC的新生儿的临床数据进行了回顾性分析.
- 具有和没有肠孔的新生儿之间的临床特征的比较.
- 后勤和LASSO回归用于识别独立的风险因素.
- 使用R软件开发一个名ogram预测模型.
- 使用ROC曲线,校准曲线和决策曲线分析验证模型.
主要成果:
- 在NEC中,肠道穿孔的发生率为26.67%.
- 肠道穿孔的独立风险因素包括血的便 (OR=5.60),APTT ≥50秒 (OR=3.22),血小板狭窄 (OR=4.74) 和低白蛋白血 (OR=5.56).
- 诺米克模型的C指数为0.838,AUC为0.838 (训练) 和0.802 (验证),显示出良好的预测能力和临床实用性.
结论:
- 血的便,长时间的APTT,血小板缺血和低蛋白血是预测NEC肠道穿孔的重要独立危险因素.
- 开发的诺莫格拉姆模型为准确识别高风险肠道穿孔的NEC患者提供了有价值的工具.
相关概念视频
01:22Esophageal Perforation-I: Introduction
94
Esophageal perforation is a severe medical condition characterized by a breach in the integrity of the esophageal wall. This breach can occur due to various factors such as trauma, medical procedures, or underlying diseases. When the esophageal wall is compromised, it allows food, fluids, and digestive juices into the chest cavity or adjacent structures, leading to potential complications and health risks.
The location of esophageal perforation can vary, occurring anywhere along the esophagus....
The location of esophageal perforation can vary, occurring anywhere along the esophagus....
94
01:28Esophageal Perforation-II: Clinical Manifestations and Management
63
Esophageal perforations manifest in various clinical forms, influenced by factors such as the perforation's cause and location (cervical, intrathoracic, or intra-abdominal), the extent of contamination, and potential injury to adjacent mediastinal structures. The timing between the perforation occurrence and treatment initiation also affects the clinical presentation.
Clinical Manifestations:
Clinical Manifestations:
63