Analysis of risk factors and establishment of prediction model for recurrence or poor efficacy in patients with myasthenia gravis
Objective To investigate the risk factors of relapse or poor outcome in myasthenia gravis(MG)patients and construct a risk prediction model.Methods The clinical data of 98 patients diagnosed with MG for the first time in the Department of Neurology,the 940 Hospital of Joint Logistic Support Forces of PLA were retrospectively collected from January 2015 to April 2022.The patients were divided into remission group and non-remission group according to the changes of the patients'conditions after 1 year of treatment,and the differences of clinical data between the two groups were compared.Multiple factor logistics regression was used to analyze the independent risk factors affecting patients'recurrence or prognosis,and a nomogram of the prediction model was established.At the same time,receiver operating characteristic(ROC)curve and calibration curve evaluated the predictive value of the model for recurrence or poor efficacy in MG patients.Results Among 98 MG patients,there were 61 patients in remission group and 37 patients in non-remission group.Compared with the remission group,MG patients in the non-remission group had longer disease course,higher MGFA type and blood aspartate aminotransferase level(all P＜0.05),and higher proportion of patients with irregular medication,infection inducement,involvement of limbs and trunk,and involvement of respiratory muscle(all P＜0.05).Multivariate logistic regression analysis suggested long course of disease(OR=1.082,95％CI:1.011-1.157;P=0.022),irregular medication(OR=4.778,95％CI:1.539-14.833;P=0.007],and an inducement of infection(OR=9.217,95％CI:2.856-29.740;P＜0.001),involved limbs and trunk(OR=3.298,95％CI:1.093-9.950;P=0.034)were independent risk factors for recurrence or poor response in MG patients.The ROC curve and calibration curve evaluation showed that the risk prediction model based on the above four independent risk factors had a good degree of differentiation and calibration.Conclusions Long course of disease,involvement of limbs and trunk,irregular medication,and infection tend to lead to recurre0nt disease or poor efficacy in MG patients.The risk prediction model established by the above risk factors has a good value in assessing the risk of recurrence or poor prognosis in MG patients.
万方数据
维普
