胃癌手术后长时间住院风险的预测模型
Xiaochun Zhang1,2, Xiao Wei1,2, Siying Lin1,2
1The First Clinical College of Nanjing University of Chinese Medicine, Nanjing, Jiangsu, China.
Frontiers in oncology
|August 21, 2024
概括
开发了一种名图,用于预测胃癌患者在术后长期住院的情况. 关键预测因素包括中性粒细胞-淋巴细胞比率和营养指数,有助于个性化风险评估和管理.
科学领域:
- 在瘤学瘤学.
- 手术结果研究研究.
背景情况:
- 胃癌 (GC) 手术后的长期术后住院 (PLOS) 是患者不良结果的重要风险因素.
- 确定PLOS的预测因素对于改善患者管理和减少医疗保健负担至关重要.
研究的目的:
- 在经过胃癌切除的患者中,开发和验证一个预测性名录,用于延长术后停留时间 (PLOS).
- 在GC患者中确定与PLOS相关的关键临床因素.
主要方法:
- 分析了404名胃癌患者的队列.
- 最小绝对收缩和选择操作员 (LASSO) 回归和物流多变量分析用于变量选择.
- 使用培训和验证队列构建并验证了一个名图,通过AUC,校准曲线和决策曲线分析评估性能.
主要成果:
- 四个临床特征被确定为PLOS的显著预测因素:术后第一天的中性粒细胞-淋巴细胞比率 (NLR),术后第三天的NLR,术前预后营养指数,以及第一次门排气的时间.
- 诺米图表显示出高预测准确度,训练组的AUC为0.990和验证组的0.983.
- 该模型显示了良好的校准,良好的适合性和临床可行性.
结论:
- 一个经过验证的诺姆图准确地预测了胃癌患者手术后长时间住院的风险.
- 这种结合关键临床因素的预测工具可以帮助在手术后增强恢复 (ERAS) 计划中的个性化风险评估和管理策略.
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