摘要
目的 分析创伤性脊髓损伤(traumatic spinal cord injury,TSC1)患者发生肺炎的危险因素,构建TSCI患者肺炎发生的风险预测模型并验证.方法 本研究为单中心回顾性临床研究,收集2016年1月1日至2020年12月31日在广西医科大学第一附属医院住院的TSCI患者的一般临床特征、实验室检查和影像学资料.采用Logistic回归筛选TSCI患者肺炎发生的危险因素,根据危险因素构建预测模型,并使用受试者工作特征曲线(ROC)、决策曲线分析(DCA)和校准曲线来验证模型性能.结果 本研究最终纳入TSCI患者共469例,删除资料不全的病例后最终纳入459例,按7∶3比例随机分为训练集(322例)和验证集(137例).其中,459例患者中按是否发生肺炎分为肺炎组和非肺炎组,肺炎患者占221例(48.15％).最终Logistic分析结果显示,完全性SCI、发热、白细胞计数异常、白蛋白异常是TSCI患者发生肺炎的独立危险因素.训练集的曲线下面积(AUC)为0.819,验证集为0.774.结论 预测模型具有较好的预测能力.完全性SCI、发热、白细胞计数、白蛋白可能是TSCI后肺炎的预测因素.
Abstract
Objective The aim of this study was to analyze the risk factors for pneumonia in patients with traumatic spinal cord injury(TSCI)and construct and validate a predictive model for assessing the risk of pneu-monia occurrence in TSCI patients.Methods This single-center retrospective clinical study included TSCI patients admitted to the First Affiliated Hospital of Guangxi Medical University between January 1,2016,and December 31,2020.Patient histories,clinical characteristics,laboratory test results,and imaging results are all recorded.Logistic regression analysis was employed to identify risk factors for pneumonia in TSCI patients.A predictive model was constructed based on these risk factors and validated using the receiver operating char-acteristic(ROC)curve,decision curve analysis(DCA),and calibration curve.Results A total of 469 TSCI patients were initially included,and after excluding cases with incomplete data,459 patients were finally ana-lyzed and randomly divided into a training set(322 cases)and a validation set(137 cases)at a 7∶3 ratio.A-mong the 459 patients,221(48.15％)developed pneumonia.Final logistic regression analysis showed that complete spinal cord injury,fever,abnormal white blood cell count(WBC)and abnormal serum albumin levels were independent risk factors for pneumonia in TSCI patients.The area under the curve(AUC)for the train-ing set was 0.819,and for the validation set,it was 0.774.Conclusion The developed prediction model demonstrated good predictive performance.Complete spinal cord injury,fever,WBC and serum albumin(ALB)levels may serve as predictive factors for pneumonia following TSCI.
基金项目
国家自然科学基金项目(81960773)
广西再生医学重点实验室开发项目(桂再重开:201705)
广西卫建委自筹研究项目(Z20170565)
维普
万方数据