Construction of a risk scoring system for primary eradication failure of Helicobacter pylori
Objective A risk scoring system for primary eradication failure of Helicobacter pylori(H.pylori)was constructed and validated.Methods A total of 967 patients diagnosed with H.pylori infection in Zhejiang Provincial People's Hospital from December 2019 to November 2021 who underwent primary H.pylori eradication therapy were selected as the study subjects,and the independent influencing factors of H.pylori eradication effect were analyzed,and a risk scoring system for H.pylori primary eradication failure was constructed.In addition,382 patients who were diagnosed with H.pylori infection for the first time in Zhejiang Provincial People's Hospital from March 2022 to February 2023 and required H.pylori eradication therapy were selected for model validation.Results Among the 967 patients who were eradicated with the standard quadruple regimen,834(86.3％)were successfully eradicated while 133(13.7％)were failed.Rural residents(OR=23.359),alcohol consumption(OR=2.187),history of H.pylori infection in family members(OR=17.319),and drug reduced or missed doses(OR=8.382)were independent risk factors for H.pylori eradication failure(all P＜0.05),and the corresponding scores were 3,1,3,and 2,respectively.The cut-off value was calculated as 2.5 points based on the Youden index,so＜3 points were defined as low risk of H.pylori eradication failure,and ≥3 points were defined as high risk of H.pylori eradication failure.The AUC of the risk scoring system for predicting H.pylori eradication failure was 0.894(95％CI:0.863-0.926,P＜0.05).The 382 patients in the model validation group were divided into the low-risk(＜3 points)group(n=270)and high-risk(≥3 points)group(n=112)for H.pylori eradication failure.After treatment with the standard quadruple regimen,53 cases(13.9％)failed to eradicate H.pylori,and the failure rate of H.pylori eradication in the high-risk group was significantly higher than that in the low-risk group(37.5％vs.4.1％,P＜0.05).The sensitivity,specificity,accuracy,positive predictive value and negative predictive value of the risk scoring system were 0.792,0.787,0.788,0.375 and 0.959,respectively.Conclusion The risk scoring system for H.pylori primary eradication failure constructed in this study includes items such as rural residence,alcohol consumption,history of H.pylori infection in family members,and drug reduced or missed doses,and the risk scoring system shows good discrimination and prediction performance.
Helicobacter pyloriInfectionEradication therapyInfluencing factorsRisk scoring system
万方数据
维普
