Risk prediction and influencing factors of residual paralysis in acute flaccid paralysis cases under 15 years of age in Jiangsu province,2012-2021
Objective To explore factors influencing residual paralysis in acute flaccid paralysis(AFP)cases and develop a risk prediction model for residual paralysis.Methods We obtained data on AFP cases under 15 years old reported to the Jiangsu AFP Case Surveillance System during 2012-2021 to determine the proportion with residual paralysis 60 days after initial paralysis and factors influencing residual paralysis.We constructed a prediction model to estimate the risk probability of residual paralysis and evaluated the model using receiver operating characteristic curve(ROC)analysis,a bootstrap method,and calibration curve analysis.Results The proportion of AFP cases＜15 years old with residual paralysis was 17.78％(367/2 064).Multivariate logistic regression analysis showed that the proportion was highest among infants and individuals with ≥2 doctor visits,who received＜3 doses of polio vaccine,who visited doctors ≥ 7 days after onset,with fever before onset,who had dyspnea during paralysis,and who had incontinence during paralysis.The risk prediction model showed that risks of residual paralysis for thesefactors rangedfrom 0.08 to 0.22,with an area under the ROC curve of 0.745(95％CI;0.715-0.774)and a C-index of 0.740.The calibration curve and Hosmer-Lemeshow tests found that the predicted risk probabilities of residual paralysis were comparable with actual values.Conclusions Residual paralysis in AFP cases was significantly associated with polio vaccination history,age,medical visits,and symptoms.A constructed risk prediction model had good prediction efficiency.
Acute flaccid paralysisResidual paralysisInfluencing factorRisk prediction model
NETL
NSTL
万方数据
