Objective To construct and validate a prediction model based on ratio of total bilirubin to albumin(B/A)to predict risk of acute bilirubin encephalopathy(ABE)in neonates with hyperbilirubinemia.Methods A total of 535 neonates with hyperbilirubinemia who hospitalized in Yellow River Sanmenxia Hospital from January 2015 to December 2022 were selected as research subjects.According to whether ABE occurred,the neonates were divided into two groups:ABE neonate group(n=96)and ABE-free neonate group(n=439).Demographic characteristics,pathological information and admission examination results of the neonates were compared between the two groups.Receiver operating characteristic(ROC)curve was use to analyze predictive value of each variable for occurrence of ABE.Univariate and multivariate Logistic regression analyses were used to evaluate influencing factors of ABE,and then a nomogram model was constructed.ROC curve and calibration curve were used to evaluate efficacy of the model,and decision curve analysis(DCA)was used to evaluate clinical practical value of the model.Results Multivariate Logistic regression analysis showed that maternal age,neonate's white blood cell count(WBC),total bilirubin,B/A ratio,hypersensitive C-reactive protein(hsCRP)were independent risk factors for occurrence of ABE[adjusted odds ratio(aOR)values were 2.548,3.640,1.236,6.289 and 1.680 respectively,all P＜0.05],and albumin was a protective factor for occurrence of ABE(aOR=0.456,P＜0.05).Then a nomogram of risk of ABE occurrence based on a total of 4 variables including maternal age,neonate's WBC,B/A ratio and hsCRP was constructed.The C-index of the model was 0.879,the AUC was 0.899(95％CI:0.869-0.930),and the calibration curve showed that the model had good discrimination ability.The DCA showed that the model benefited to the neonates more in actual clinical work.Conclusion B/A ratio is an independent factor and an effective predictor of ABE in neonates with hyperbilirubinemia.
关键词
急性胆红素脑病/危险因素/列线图/总胆红素与白蛋白比值
Key words
acute bilirubin encephalopathy/risk factor/nomogram/total bilirubin to albumin ratio
万方数据