Nomogram model and predictive value for stroke risk in COPD patients based on CHA2DS2-VASc score
Objective To develop a predictive model for stroke risk in patients with chronic obstructive pulmonary disease(COPD)and compare its value with the CHA2DS2-VASc score in predicting stroke risk in COPD patients.Methods A total of 213 COPD patients hospitalized in this center from 2022 to 2023 were en-rolled and followed up for one year to collect data on new-onset stroke events.The patients were divided into a stroke group(45 cases)and a non-stroke group(168 cases)based on whether they experienced a stroke,and differences in various indicators between the two groups were compared.Logistic regression analysis was con-ducted to investigate various factors influencing stroke occurrence in COPD patients,a nomogram model was established and internally validated,and the receiver operating characteristic(ROC)curve method was applied to evaluate the predictive role of the nomogram model and the CHA2DS2-VASc score in stroke onset among COPD patients.Results Logistic regression analysis confirmed that age,independent living,history of stroke,anticoagulant therapy,and CHA2DS2-VASc score were independent influencing factors for stroke occurrence in COPD patients[odds ratio(OR)95％ confidence interval(95％ CI)were 3.398(1.380-8.371),0.281(0.102-0.775),18.869(2.324-153.217),0.006(0.001-0.043),and 2.079(1.345-3.216),respectively,P＜0.05].Based on these factors,a nomogram model was constructed,with an area under the ROC curve(AUC)of 0.904(95％ CI:0.852-0.955),a sensitivity of 89.9％,and a specificity of 77.8％,indicating good discrimination of the model.The Hosmer-Lemeshow goodness-of-fit test showed X2=3.500,P=0.744,indi-cating good calibration of the model.The Delong test showed that the nomogram model had higher predictive value than the CHA2DS2-VASc score(AUC=0.741)(Z=5.610,P＜0.001).Conclusion The constructed nomogram model demonstrates good discrimination and calibration and can effectively improve the predictive value for stroke occurrence in COPD patients,thereby providing a scientific basis for early assessment and timely intervention in stroke-risk groups among COPD patients.
CHA2DS2-VASc scoreNomogram modelStrokeChronic obstructive pulmonary diseasePredictive value
万方数据
维普
