Risk factors of epileptic seizure after open brain glioma resection and its construction of prediction model
Objective To construct an prediction model for early epileptic seizures after craniotomy for open brain glioma resection.Methods The clinical data of 240 patients admitted to our hospital after craniotomy for glioma be-tween April 2020 and December 2023 were reviewed,and the patients were divided into the epileptic and the non-epi-leptic groups according to the presence or absence of seizures in the early postoperative period.A multivariate logis-tic regression analysis was used to analyze the risk factors for early epileptic seizure,and a risk prediction model for early epileptic seizure was constructed based on the results of the logistic regression analysis.The model was evalua-ted using C-index,calibration curve,and receiver operating characteristic(ROC)curve.Results The early epileptic seizure rate after craniotomy for glioma resection was 19.17％.The results of logistic regression analysis showed that preoperative epilepsy history,pathological grade Ⅱ,no prophylaxis with AEDs,maximum tumour diameter≥5 cm,and involvement of the cortex were all independent risk factors for early epileptic seizure after craniotomy for glioma(P＜0.05).A prediction model was constructed logit(P)=-1.154+1.235 X preoperative epilepsy history+0.453 × pathological grade Ⅱ+0.822 × no prophylaxis with AEDs+0.316 × maximum tumour diameter≥5 cm+1.421 × involvement of the cortex.Bootstrap method was used to internal validation of the model,and the results showed that C-index was 0.807(95％CI was 0.725-0.892).The plotted calibration curve analysis showed Hos-mer-Lemeshow x2=0.612,P=0.322.The ROC curve was plotted to validate the model's internal predictive effica-cy,and its results showed that an area under the curve(AUC)was 0.893(95％CI was 0.847-0.929,P＜0.05),a sensitivity of 93.48％,a specificity of 80.93％,and Youden index of 0.744.Conclusion The preoperative history of epilepsy,low pathological grade,large tumor,no preventive anti-epileptic drugs,and cortical involvement are all risk factors for early postoperative epilepsy in patients with brain glioma,and the constructed prediction model based on this method has good differentiation and fitting,and is of high early warning value for clinical identification of ear-ly postoperative seizures in glioma.
glioma resectionearly epileptic seizurerisk factorsprediction model
万方数据
维普
