Influencing factors of short-term prognosis after drilling and drainage surgery for chronic subdural hematoma and establishing a No-mogram prediction mode
Influencing factors of short-term prognosis after drilling and drainage surgery for chronic subdural hematoma and establishing a No-mogram prediction mode
Objective To analyze the factors influencing the short-term prognosis of chronic subdural hematoma after trepanation and drainage and establish a Nomogram prediction model.Methods A total of 336 patients with chronic subdural hematoma admitted to the Depart-ment of Neurosurgery,Ruijin Hospital Affiliated to Shanghai Jiao Tong University School of Medicine from 2015 to 2022 were retrospectively select-ed as the study objects.The patients were divided into good prognosis group(n=241)and poor prognosis group(n=95)according to whether there was poor prognosis at follow-up within 1 month after surgery.Thirteen factors that may be related to the recurrence of chronic subdural he-matoma after operation were analyzed and compared.Variables with statistically significant differences were included in multiple Logistic regression analysis,and a risk prediction model was constructed.A Nomogram model for predicting poor short-term prognosis after drill-drainage of chronic subdural hematoma was established by Rstudio for visualization.The receiver operating characteristic(ROC)curve of subjects were drawn to eval-uate the predictive efficacy of the risk prediction model for poor prognosis after trepanation and drainage of chronic subdural hematoma.Results In this study,a total of 336 patients with chronic subdural hematoma were collected,and 95 patients had adverse reactions,accounting for 28.27％.Multiple Logistic regression analysis showed that age,cerebral atrophy,cerebral reexpansion,preoperative hematoma width,preoperative midline shift,postoperative subdural space,and midline shift degree at discharge were risk factors for the short-term prognosis of chronic subdural hema-toma after trepanation and drainage(P＜0.05).Based on the results of multiple Logistic regression analysis,a Nomogram model was established to predict the risk of short-term adverse prognosis after trepulation and drainage of chronic subdural hematoma.The consistency index of the no-mogram was 0.796(0.693-0.867),indicating that the prediction of this nomogram was in good agreement with the actual observation.The area of ROC curve was 0.942,95％CI:0.887-0.982,Youden index was 0.586,sensitivity was 92.46％,specificity was 78.25％,indicating that the model had good differentiation.Conclusion Age,cerebral atrophy,cerebral reexpansion,preoperative hematoma width,preoperative midline displacement,postoperative subdural space,midline deviation degree at discharge are risk factors for the short-term prognosis of chronic subdural hematoma after trepanation and drainage.The established Nomogram prediction model has a good degree of differentiation and calibration,which can effectively assist the medical staff to effectively identify the high-risk groups with poor prognosis after trepanation and drainage of chronic sub-dural hematoma,and take targeted measures to reduce the risk of poor prognosis after trepanation and drainage.
关键词
慢性硬膜下血肿/预后/钻孔引流术/影响因素/预测模型
Key words
Chronic subdural hematoma/Prognosis/Trepanation and drainage/Influencing factors/Prediction model
维普
万方数据