开发和验证一个预测模型的失明后透镜提取手术在急性初级角度关闭一个队列研究后的失明
Yining Guo1,2, Chendi Li3,4, Zhongping Luo5
1Department of Ophthalmology, Peking University Third Hospital, Beijing, China.
International journal of surgery (London, England)
|November 19, 2025
概括
一种新的考克斯回归名图有效地预测了急性初级角度闭合 (APAC) 患者在透镜摘取 (LE) 手术后的失明. 这种工具有助于分层患者的风险和指导临床决策,以获得更好的结果.
科学领域:
- 眼科医生 眼科 眼科
- 临床预测模型临床预测模型
- 外科手术的结果
背景情况:
- 急性初级角闭合 (APAC) 是一种严重的疾病,可能导致失明.
- 透镜提取 (LE) 手术是亚太地区的常见治疗方法.
- 预测亚太地区LE手术后患者的失明风险对于管理至关重要.
研究的目的:
- 开发和验证基于考克斯回归的名图.
- 预测在接受LE手术的APAC患者中失明的风险.
- 为临床决策和风险分层提供一个工具.
主要方法:
- 多中心,回顾性的纵向研究.
- 包括培训 (254只眼睛) 和验证 (111只眼睛) 队列.
- 考克斯回归分析以确定失明预测因素.
- 使用ROC曲线,AUC,C指数和校准图表评估的诺莫格拉姆表现.
主要成果:
- 确定了重要的预测因素:logMAR视敏度,曼尼托尔使用,手术时间,手术前的logMAR VA和手术前的眼内压力.
- 在培训 (0.860) 和验证 (0.826) 队列中,高一致性指数 (C指数) 很高.
- 在1年和5年的曲线下面积 (AUC) 值非常好,并观察到强烈的校准.
结论:
- 开发的诺米图谱是预测亚太地区患者LE手术后失明的有效工具.
- 诺米图表促进了风险分层,使得个性化临床管理成为可能.
- 该工具支持治疗亚太地区患者的眼科医生做出明智决策.
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