开发和验证基于活动因子预测术后复发性腰椎椎间板的诺米克图
Ming Tang1,2, Siyuan Wang1, Yiwen Wang1
1Department of Interventional Vascular Medicine, Hefei Hospital Affiliated to Anhui Medical University, The Second People's Hospital of Hefei, Hefei City, Anhui Province, People's Republic of China.
Risk management and healthcare policy
|March 28, 2024
概括
使用术后活动因子的新预测模型可以准确地识别通过皮肤内透视晶椎间盘切除术 (PETD) 后患有复发腰椎间盘瘤风险的患者. 这种工具有助于个性化风险评估,以获得更好的患者结果.
科学领域:
- 神经外科 神经外科
- 整形外科 整形外科 整形外科
- 医疗信息学 医疗信息学
背景情况:
- 手术后的复发性腰椎间盘 (PRLDH) 在皮肤内透视转椎间盘切除术 (PETD) 后构成重大挑战.
- 需要预测模型来识别PRLDH高风险患者,以实现个性化管理策略.
研究的目的:
- 开发和验证PETD后PRLDH的个性化预测模型.
- 该模型结合了术后活动因素,以提高预测的准确性.
主要方法:
- 对接受PETD的612名患者的回顾性分析.
- 拉索回归和随机森林模型用于变量选择和预测.
- 模型性能使用AUC,校准,DCA和AIC进行评估,并通过Bootstrap和交叉验证进行内部验证.
主要成果:
- 在612名患者中,66名患者 (10.78%) 经历了PRLDH.
- 拉索回归模型 (模型1) 与随机森林模型相比,显示出优异的预测性能 (AUC: 0.813培训,0.868验证).
- 确定的主要预测因素包括BMI,吸烟,活动水平,行走时间,糖尿病,Modic变化和Pfirrmann等级.
结论:
- 开发的Nomogram预测模型,基于术后活动因素,在评估PETD后的PRLDH风险方面表现出很好的能力.
- 这种工具可以帮助临床医生对接受PETD的患者进行个性化风险分层.
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