首页|胶质瘤术后静脉血栓栓塞症风险预测模型的构建及验证

胶质瘤术后静脉血栓栓塞症风险预测模型的构建及验证

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目的 分析胶质瘤患者术后并发静脉血栓栓塞(venous thromboembolism,VTE)的危险因素,并构建Nomogram模型.方法 收集2018年9月~2023年4月徐州医科大学附属医院收治的401例胶质瘤患者的临床资料,采用单因素和多因素Logistic回归分析探讨胶质瘤发生VTE的危险因素.构建Nomogram模型后,采用受试者工作特征(receiver operating characteris-tic,ROC)曲线检验模型的鉴别效能,Calibration校准曲线评价模型的校准度,Hosmer-Lemeshow拟合优度检验模型的校准曲线,Bootstrap自抽样法对模型进行内部验证,决策曲线分析(decision curve analysis,DCA)评价其临床获益性.结果 Logistic回归分析结果显示,年龄、体重指数、血小板、白细胞、D-二聚体、IDH表型为胶质瘤术后发生VTE的独立危险因素;Nomogram模型预测胶质瘤术后发生VTE的ROC曲线下面积为0.898;校准曲线、C指数和外部验证提示模型具有较高的准确性,DCA结果显示模型具有较好的临床有效性.结论 本研究基于胶质瘤患者术后发生VTE的危险因素构建的预测模型,经内、外部验证后,显示诊断效能良好,能够为临床决策提供依据.
Construction and Validation of Risk Prediction Model for Venous Thromboembolism After Glioma Surgery
Objective To analyze the risk factors of postoperative complication of venous thromboembolism(VTE)in glioma pa-tients,and to construct Nomogram model.Methods The clinical data of 401 glioma patients admitted to the Affiliated Hospital of Xuzhou Medical University from September 2018 to April 2023 were collected,and the risk factors of VTE in glioma were explored using univariate analysis and multivariate Logistic regression analysis.After constructing the Nomogram model,the discriminative efficacy of the model was examined using the receiver operating characteristic(ROC)curve,the calibration degree of the model was evaluated by calibration curve,the calibration curve was examined by the Hosmer-Lemeshow goodness-of-fit test,the model was internally validated using the Boot-strap self-sampling method,and the clinical benefit was analyzed by the decision curve analysis(DC A).Results Logistic regression a-nalysis showed that age,body mass index,platelets,leukocytes,D-dimer,and IDH phenotype were independent risk factors for the oc-currence of VTE after glioma surgery;the Nomogram model predicted that the area under the ROC curve for the occurrence of VTE after glioma surgery was 0.898;the calibration curves,C-index,and external validation suggested that the model had a high degree of accura-cy,and the DCA showed that the model had good clinical validity.Conclusion The prediction model constructed based on the risk fac-tors for postoperative VTE in glioma patients in this study was internally and externally validated,showing good diagnostic efficacy and pro-viding a basis for clinical decision-making.

GliomasVenous thromboembolismRisk factorsNomogram

邓李轶、章宇顺、王雷、张桐、徐义强、刘勇

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221000 徐州医科大学附属医院神经外科

胶质瘤 静脉血栓栓塞症 危险因素 列线图

国家自然科学基金青年科学基金资助项目江苏省徐州市科技重点研发计划项目

82002632KC20139

2024

医学研究杂志
中国医学科学院

医学研究杂志

CSTPCD
影响因子:0.702
ISSN:1673-548X
年,卷(期):2024.53(7)