Analysis of Influencing Factors of Stress Ulcer Secondary to Severe Craniocerebral Injury Based on Nomogram Prediction Model
Objective:To explore the influencing factors of stress ulcer secondary to severe craniocerebral injury(sTBI),and to construct a nomogram prediction model.Methods:116 sTBI patients diagnosed and treated in our hospital from May 2022 to May 2023 were selected as the research objects,patients were divided into occurrence group(n=35)and non-occurrence group(n=81)according to whether secondary stress ulcer occurred.The clinical data in two groups were collected,the influencing factors of secondary stress ulcer in sTBI patients were analyzed univariate and multivariate Logistic regression models,and a nomogram prediction model was constructed,the predictive value of secondary stress ulcer in sTBI patients was analyzed by receiver operating characteristic(ROC)curve.Results:Stress ulcer secondary to sTBI was related to admission Glasgow Coma Scale Method(GCS)score,random blood glucose level,hemoglobin(Hb),time from injury to admission,gastrin(GAS)and other factors(P＜0.05).Multivariate Logistic regression model analy-sis showed that,elevated random blood glucose level and elevated GAS level were independent risk factors for secondary stress ulcer in sTBI patients(P＜0.05).Admission GCS score of 6～8 points and elevated Hb level were independent protective factors(P＜0.05).The results of ROC analysis showed that,the area under the curve(AUC)of admission GCS score,random blood glucose level,Hb,GAS and nomogram prediction model for predicting secondary stress ulcer in sTBI patients were 0.773,0.745,0.781,0.695 and 0.960 respectively,and the AUC of nomogram prediction model was higher than that of each single index,suggesting that the nomogram prediction model had higher predictive value for secondary stress ulcer in sTBI patients.The internal verification of Bootstrap method(B=1 000)shows that the prediction curve after correcting the deviation basically coincides with the ideal line,and the concordance index(C-index)was 0.921,indicating that the model has good prediction ability.The decision analysis shows that the threshold probability range was 0.03～0.93,and the net return rate was greater than 0,which exceeds two invalid lines.Conclusion:The secondary stress ulcer of sTBI is closely relate to admission GCS score,random blood glucose level,Hb and GAS,the nomogram prediction model construct by the above indices,which can increase the risk of predicting secondary stress ulcer in sTBI patients,and is helpful for early clinical intervention and treatment.
Severe craniocerebral injuryStress ulcerInfluencing factorsPredictive value
NETL
NSTL
万方数据
