Abstract
Background Vasovagal syncope(VVS)is the most common type of orthostatic intolerance in children.We investigated whether platelet-related factors related to treatment efficacy in children suffering from VVS treated with metoprolol.Methods Metoprolol-treated VVS patients were recruited.The median duration of therapy was three months.Patients were followed and divided into two groups,treament-effective group and treatment-ineffective group.Logistic and least absolute shrinkage selection operator regressions were used to examine treatment outcome variables.Receiver-operating character-istic(ROC)curves,precision-recall(PR)curves,calibration plots,and decision curve analyses were used to evaluate the nomogram model.Results Among the 72 patients who complete the follow-up,treatment-effective group and treatment-ineffective group included 42(58.3％)and 30(41.7％)cases,respectively.The patients in the treatment-effective group exhibited higher mean platelet volume(MPV)[(11.0±1.0)fl vs.(9.8±1.0)fl,P＜0.01]and platelet distribution width[12.7％(12.3％,14.3％)vs.11.3％(10.2％,12.2％),P＜0.01]than those in the treatment-ineffective group.The sex ratio was significantly different(P=0.046).A fit model comprising age[odds ratio(OR)=0.766,95％confidence interval(CI)=0.594-0.987]and MPV(OR=5.613,95％CI=2.297-13.711)might predict therapeutic efficacy.The area under the curve of the ROC and PR curves was computed to be 0.85 and 0.9,respectively.The P value of the Hosmer-Lemeshow test was 0.27.The decision curve analysis confirmed that managing children with VVS based on the predictive model led to a net advantage ranging from 0.01 to 0.58.The nomogram is convenient for clinical applications.Conclusion A novel nomogram based on age and MPV can predict the therapeutic benefits of metoprolol in children with VVS.
基金项目
National High-Level Hospital Clinical Research Funding(2022CR59)
Clinical Medicine Plus X-Young Scholars Project(PKU2022LCXQ028)
Fundamental Research Funds for the Central Universities,China()
NETL
NSTL
万方数据