开发和验证风险预测模型,以评估激进囊切除术后静脉血栓栓塞的风险
Chin-Hui Lai1,2, Jiaxiang Ji1,2, Mingrui Wang1,2
1Department of Urology, Peking University People's Hospital, Beijing, China.
Translational andrology and urology
|October 22, 2024
概括
这项研究开发了新的模型来预测激进囊切除术 (RC) 后静脉血栓栓塞 (VTE) 风险,优于目前的卡普里尼风险评估 (CRA) 模型. 模型A为RC患者早期VTE风险识别提供了一个更简单,更有效的工具.
科学领域:
- 泌尿器科 泌尿器科 泌尿器科 泌尿器科
- 在瘤学瘤学.
- 心血管医学 心血管医学
背景情况:
- 激进囊切除术 (RC) 患者面临高风险的静脉血栓塞栓症 (VTE).
- 现有的预测模型,如卡普里尼风险评估 (CRA) 模型,在准确性上有局限性.
- 需要在后RC人群中改进VTE风险预测.
研究的目的:
- 开发和验证VTE风险的新型预测模型,以彻底切除囊.
- 将新模型的性能与已建立的CRA模型进行比较.
- 为了确定一个更准确和临床上适用于RC患者VTE风险分层的工具.
主要方法:
- 一个单一中心对272名RC患者 (2010-2019) 的回顾性研究.
- 患者被随机分配到训练和测试队列中.
- 使用多变量和阶段物流回归来开发两个新的预测模型 (模型A和模型B),与使用NRI,IDI和ROC分析的CRA模型进行比较.
主要成果:
- 在272名患者中,36名患者在RC后发展了VTE.
- 模型A和模型B都显示出比CRA模型更高的预测准确度 (ROC AUC分别为0.806和0.833).
- 新型模型在分类和预测方面显示出显著的改进 (NRI>0,IDI>0,P<0.01) 和在决策曲线分析中有利的临床效用.
结论:
- 开发的模型在RC后的VTE风险预测方面明显优于目前的CRA模型.
- 具有较少变量的A模型对于易于使用和快速风险评估特别有利.
- 这些模型可以促进及时干预,可能改善高风险RC患者的治疗结果.
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