Study on the factors affecting poor prognosis and risk prediction in children with spastic cerebral palsy receiving rehabilitation treatment
Objective To investigate the risk factors for poor prognosis in children with spastic cerebral palsy receiving rehabilitation treatment,and to establish a risk prediction model.Methods A total of 168 children with spastic cerebral palsy,including 105 boys and 63 girls,aged(6.75±2.04)years,who received rehabilitation treatment in Xi'an Traditional Chinese Medicine Brain Disease Hospital from January 2018 to March 2023,were retrospectively included.They were divided into a poor prognosis group and a good prognosis group based on the prognosis after one year of following-up.The clinical data of the two groups were compared,and the influencing factors for poor prognosis in children with spastic cerebral palsy were analyzed by multivariate logistic regression analysis.A Nomogram model to predict the risk of poor prognosis in children was constructed,and the predictive value of the model was validated.x2 test was used.Results The proportions of severe illness,quadriplegia,severe abnormalities of amplitude integrated electroencephalogram(aEEG),and malnutrition in the good prognosis group were lower than those in the poor prognosis group[32.11％(35/109)vs.55.93％(33/59),12.84％(14/109)vs.28.81％(17/59),13.76％(15/109)vs.59.32％(35/59),22.94％(25/109)vs.40.68％(24/59)],with statistically significant differences(all P＜0.05).Multivariate logistic regression analysis showed that severe illness,quadriplegia,severe abnormality of aEEG,and malnutrition were all risk factors for poor prognosis in children with spastic cerebral palsy after rehabilitation treatment(all P＜0.05).A Nomogram model for predicting the risk of poor prognosis in children with spastic cerebral palsy after rehabilitation treatment was constructed based on the four risk factors screened through multiple logistic regression analysis.The model was validated,and the calibration curve showed that the calibration curve fitted well with the ideal curve,and the receiver operating characteristic curve(ROC)showed that the area under the curve,sensitivity,and specificity were 0.881,84.75％,and 83.05％,respectively,and the decision curve showed that when the threshold probability was from 0.29 to 0.94,the model predicted that poor prognosis of rehabilitation treatment for children with spastic cerebral palsy could achieve net benefits.Conclusions Severe illness,spastic quadriplegia,severe abnormalities of aEEG,and malnutrition are all risk factors for poor prognosis in children with spastic cerebral palsy after rehabilitation treatment,and the Nomogram model for predicting the risk of poor prognosis in children constructed based on the above factors has good predictive value,and it can be used to guide clinical screening of high-risk children with poor prognosis,so as to adjust treatment plans in a timely manner.
Spastic cerebral palsyChildrenRehabilitation therapyPrognosisInfluencing factorsNomogram model
万方数据
维普
