乳腺癌患者化疗所致恶心呕吐预防失败的危险因素分析与预测模型建立
Risk factors and prediction modeling for prevention failure of chemotherapy-related nausea and vomiting in breast cancer patients
魏浩洁 1武东 1黄灿 2杨振峰 1孙翠玲 3李广利 1汪晓娟4
作者信息
- 1. 阜阳市人民医院药剂科,安徽阜阳 236000
- 2. 安庆市立医院药事管理科,安徽安庆 246000
- 3. 阜阳市人民医院肿瘤科,安徽阜阳 236000
- 4. 阜阳市人民医院教务部,安徽阜阳 236000
- 折叠
摘要
目的:探讨乳腺癌患者化疗所致恶心呕吐预防失败的影响因素,并构建预测模型.方法:回顾性选取2022年1月至2023年12月阜阳人民医院接受化疗的乳腺癌患者为研究对象.依据化疗所致恶心呕吐预防是否失败将患者分为失败组和对照组.采用多因素logistic回归分析乳腺癌患者化疗所致恶心呕吐预防失败的影响因素,并构建预测模型;ROC曲线分析乳腺癌患者化疗所致恶心呕吐预防失败的预测价值.结果:纳入450例患者,其中化疗所致恶心呕吐预防失败130例.数字评分量表(NRS)(OR=0.501,95％CI:0.350～0.716,P＜0.01)、焦虑状态(OR=4.169,95％CI:2.175～7.991,P＜0.01)、高致吐风险(OR=68.528,95％CI:8.807～533.203,P＜0.01)、中致吐风险(OR=3.154,95％CI:1.686～5.902,P＜0.01)、低致吐风险(OR=5.367,95％CI:2.280～12.632,P＜0.01)、华蟾素胶囊(OR=12.780,95％CI:6.321～25.836,P＜0.01)、白蛋白水平(OR=0.923,95％CI:0.862～0.989,P=0.023)为预防失败的独立危险因素(P＜0.05),据此建立logistic回归方程Logit(P1)=0.297-0.692×NRS+1.428×焦虑状态+4.227×高致吐风险或1.149×中致吐风险或1.680×低致吐风险+2.548×华蟾素胶囊-0.08×白蛋白水平,内部和外部验证集验证模型准确率分别为91.67％和86.67％.结论:基于NRS、焦虑状态、高致吐风险、中致吐风险、低致吐风险、华蟾素胶囊、白蛋白水平构建的乳腺癌患者化疗所致恶心呕吐预防失败的预测模型性能良好.
Abstract
OBJECTIVE To explore the influencing factors of prevention failure of chemotherapy-induced nausea and vomit-ing(CINV)in breast cancer patients and construct its prediction model.METHODS From January 2022 to December 2023,ret-rospective study was conducted for 450 breast cancer patients on chemotherapy at Fuyang People's Hospital.They were assigned into two groups of failure and control according to whether or not there was prevention failure of CINV.Multivariate logistic regression analysis was performed for examining the influencing factors of prevention failure of CINV.Receiver operating charac-teristic(ROC)curve was plotted for exploring the value of prediction model for prevention failure of CINV.RESULTS Among them,130 cases had prevention failure of CINV.Numeric rating scale(NRS)(OR=0.501,95％CI:0.350-0.716,P＜0.01),anxiety status(OR=4.169,95％CI:2.175-7.991,P=0.000),high risk of vomiting(OR=68.528,95％CI:8.807-533.203,P＜0.01),risk of intermediate vomiting(OR=3.154,95％CI:1.686-5.902,P＜0.01),low risk of vomiting(OR=5.367,95％CI:2.280-12.632,P＜0.01),oral preparation of proprietary Chinese medicine(OR=12.780,95％CI:6.321-25.836,P＜0.01)and serum albumin(OR=0.923,95％CI:0.862-0.989,P=0.023)were independent risk factors for prevention failure of CINV.Logit(P1)=0.297-0.692×NRS+1.428×anxiety status+4.227×high risk of vomiting or 1.149×risk of intermedi-ate vomiting or 1.680×low risk of vomiting+2.548×cinobufacini capsule-0.08×serum albumin,the accuracy of internal and extemal validation sets was 91.67％and 86.67％respectively.CONCLUSION The risk prediction model constructed based upon NRS/anxiety status/high risk of vomiting/risk of intermediate vomiting/low risk of vomiting/cinobufacini capsule/serum albumin has demonstrated an excellent performance.
关键词
化疗所致恶心呕吐/乳腺癌/预测模型/危险因素Key words
chemotherapy-related nausea and vomiting/breast cancer/predictive model/risk factors引用本文复制引用
出版年
2024
NETL
NSTL
万方数据