Analysis of risk factors and construction of predictive model for frailty syndrome in patients with radiotherapy for esophageal cancer
Objective To analyze the risk factors of asthenic syndrome in patients with radiotherapy for esophageal cancer,and estab-lish a risk prediction model.Methods A total of 140 patients with esophageal cancer who received radiotherapy in a specialized hospital in Anhui province from April 2020 to March 2023 were selected as the study objects by convenient sampling method.Univariate analysis and lo-gistic regression were used to analyze the risk factors for developing frailty syndrome in patients with esophageal cancer radiotherapy,and the risk prediction model was constructed.Hosmer-Lemeshow was used to test the goodness of fit of the frailty model,and receiver operating char-acteristic(ROC)curve was used to test the prediction effect of the model.Results The incidence of asthenic syndrome in 140 patients with ra-diotherapy for esophageal cancer was 43.57%(62/140).Age,concurrent chemotherapy,swallowing function,anxiety,depression,nutritional risk and self-management level were independent risk factors for the development of the debilitating syndrome(P<0.05).The regression fitting equation was constructed according to the meaningful variables in the multivariate analysis as Logit(P)=-10.374+0.125×age+1.334×concur-rent chemoradiotherapy+0.593×swallowing function+0.967×HADS-A+1.038×HADS-D+1.271×nutritional risk-0.057×self-administered level.Hosmer-Lemeshow test results indicated that the risk prediction model had a good fit(χ2=6.974,P=0.539).Model verification results showed that the area under ROC curve was 0.899,95%CI was(0.847~0.952),the Yodon index was 0.717,the optimal critical value was 0.446,the sensitivity and specificity was 86.9%and 84.8%,respectively,and the actual application accuracy was 85.0%.Conclusion The estab-lished risk prediction model has a good prediction effect,which can provide a reference for clinical staff to identify the risk of debilitating syn-drome in patients with esophageal cancer radiotherapy in early stage and make preventive intervention plans.
Esophageal cancerRadiotherapyFrailty syndromeRisk factorsPrediction model