预测二极性障碍的治疗患者慢性病的10年风险:风险模型开发和内部交叉验证研究
Joe Kwun Nam Chan1, Marco Solmi2, Christoph U Correll3
1Department of Psychiatry, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong.
概括
这项研究开发了慢性病 (CKD) 在双相情感障碍 (BD) 患者治疗的10年风险模型. 该模型确定了关键的风险因素,包括年龄,性别,并发症和水平,有助于个性化患者护理.
科学领域:
- 腎臟病學 (nephrology) 是一種醫學.
- 精神病学是一个精神病学.
- 数据科学数据科学数据科学
背景情况:
- 是双相情感障碍 (BD) 的首要治疗方法,但具有慢性病 (CKD) 的风险.
- 对于在治疗的BD患者中预测CKD的研究有限,特别是在亚洲人群中.
研究的目的:
- 在首次诊断的BD患者接受的CKD第3阶段的10年风险预测模型的推导和验证.
- 确定该患者队列中CKD发展的独立风险因素.
主要方法:
- 利用香港公共卫生保健服务 (2002-2018) 的电子医疗记录.
- 应用最小绝对收缩和选择运算符 (LASSO) 考克斯回归与内部交叉验证.
- 包括人口统计学,并发症,血清水平和精神药物使用作为预测因素.
主要成果:
- 鉴定了2,258名治疗的BD患者,CKD发病率为每1000人/年12.6.
- 慢性病的独立风险因素包括诊断时的年龄较大,男性性别,并发症,更高的平均水平和特定的精神药物治疗模式.
- 10年风险模型显示了令人满意的预测性能 (AUC=0.74) 和歧视 (C指数=0.75).
结论:
- 为治疗的BD患者开发了一种经过验证的10年CKD风险预测模型.
- 该模型在占主导地位的中国人口中表现良好.
- 建议进一步进行外部验证,以便在个性化患者管理中临床实施.
相关概念视频
01:24Mania and Antimanic Drugs: Overview
103
Mania, a psychological condition characterized by elevated mood, increased energy, and reduced sleep need, is part of the bipolar disorder cycle. The exact cause of mania isn't entirely known, but it is thought to be a combination of genetic, environmental, and neurological factors. Bipolar disorder involves alternating manic and depressive episodes. Mood stabilizers like lithium, antipsychotics, and anticonvulsants help manage these episodes. Lithium carbonate is particularly effective as...
103
01:17Factors Affecting Renal Clearance: Renal Impairment
35
Renal dysfunction significantly impairs the renal clearance of drugs, leading to potential complications in drug therapy. Renal failure, which can be caused by various factors, poses a significant challenge in the elimination of drugs from the body.
One condition associated with renal failure is uremia. Uremia is characterized by impaired glomerular filtration and fluid accumulation in the body. This condition hinders the renal clearance of drugs, resulting in drug accumulation and potential...
One condition associated with renal failure is uremia. Uremia is characterized by impaired glomerular filtration and fluid accumulation in the body. This condition hinders the renal clearance of drugs, resulting in drug accumulation and potential...
35
01:11Renal Failure: Dose Adjustments
37
In patients with renal impairment, drugs undergo significant changes in their pharmacokinetics, which require dosage adjustments to ensure safe and effective therapy.
Reduced renal clearance and elimination rate are common outcomes of renal impairment. These alterations lead to a prolonged elimination half-life and an altered apparent volume of distribution for drugs. As a result, dosage adjustments are typically necessary to maintain optimal drug levels in the body.
However, dosage adjustments...
Reduced renal clearance and elimination rate are common outcomes of renal impairment. These alterations lead to a prolonged elimination half-life and an altered apparent volume of distribution for drugs. As a result, dosage adjustments are typically necessary to maintain optimal drug levels in the body.
However, dosage adjustments...
37
01:28Antihypertensive Drugs: Potassium-Sparing Diuretics
410
Liddle syndrome is a genetically inherited form of hypertension characterized by the overactivity of epithelial sodium channels in the nephron, the functional unit of the kidney. This heightened activity leads to increased sodium reabsorption and excessive excretion of potassium. To counteract this, potassium-sparing diuretics such as amiloride are used. They function by blocking these sodium channels, thereby reducing the influx of sodium into the epithelial cells and minimizing the loss of...
410
01:30Bipolar Disorder
38
Bipolar disorder is a chronic mental health condition marked by significant mood fluctuations, including episodes of mania and depression. Elevated energy levels, heightened mood or irritability, impulsive behavior, reduced sleep needs, rapid speech, racing thoughts, inflated self-esteem, and distractibility characterize mania. Individuals with bipolar disorder often alternate between depressive and manic states, with periods of emotional stability lasting an average of six months to a year.
38
01:33Hormonal Regulation
32.7K
The renin-aldosterone system is an endocrine system which guides the renal absorption of water and electrolytes, thus managing blood pressure and osmoregulation. Activation of the system begins in the kidneys with a small cluster of cells adjacent to the afferent and efferent blood vessels of the renal corpuscle. As the nephrons are filtering blood, juxtaglomerular cells monitor blood pressure. If they detect a decrease in pressure, they release the hormone renin into the bloodstream.
32.7K