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早期临床评估中的二次与初级脊髓感染:一种节,耐泄漏的建模方法与内部验证:一个多中心的回顾性研究
Merih Can Yilmaz1, Ozgur Ozaydin2, Cengiz Cokluk3
1Department of Neurosurgery, VM Medical Park Hospital, 55200 Samsun, Turkey.
Journal of clinical medicine
|March 14, 2026
概括
慢性病 (CKD) 与原发性脊髓感染有关,而糖尿病 (DM) 与二次脊髓感染有关. 了解这些并发病模式有助于分类脊髓炎感染病因.
科学领域:
- 传染性疾病 传染性疾病
- 腎臟病學 (nephrology) 是一種醫學專業.
- 内分泌学 在内分泌学.
- 脊柱外科手术 脊柱外科手术
- 生物统计学 生物统计学
背景情况:
- 脊髓感染多种多样,需要病因学分类才能有效诊断和治疗.
- 慢性病 (CKD) 和糖尿病 (DM) 等并发症可能会影响脊髓感染的病因.
- 多中心数据对于理解伴随性疾病和脊柱感染类型之间的复杂相互作用至关重要.
研究的目的:
- 评估脊柱感染的多中心队列中的病因模式.
- 调查CKD,DM和初级与二级脊柱感染病因之间的关联.
- 贡献新的洞察力,了解共发病概况在脊柱感染分类中的作用.
主要方法:
- 采用了峰惩罚后勤回归 (L2) 模型,并进行了嵌套交叉验证,以进行可靠的概率估计.
- 优化模型参数 (惩罚参数C) 使用日志损失最小化来防止数据泄露.
- 进行了补充的Firth-penalized分析以验证,使用CKD/DM阴性患者作为参考组.
主要成果:
- 该模型有效地区分了脊柱感染概率概况 (OOF AUC 0.762).
- 糖尿病患者的二次脊髓感染概率高 (84.4%),与CKD患者的初级感染概率高 (84.6%).
- 没有观察到CKD和DM的病例;分析仅限于相关的患者层.
结论:
- 慢性病 (CKD) 主要与原发性脊髓感染病因相关.
- 糖尿病 (DM) 更常与二次脊髓炎感染病因有关.
- 同病概况显著影响脊柱感染的病因分类,需要在更大的队列中进一步调查.
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