文章摘要
卢凯，叶晓东，朱遂强.脑出血微创手术患者预后预测模型的建立[J].神经损伤功能重建,2022,17(4):204-207
脑出血微创手术患者预后预测模型的建立
A Model to Predict Prognosis for Intracerebral Hemorrhage Patients after Minimally InvasiveSurgery
  
DOI：
中文关键词: 脑出血  微创手术  列线图  预后
英文关键词: intracerebral hemorrhage  minimally invasive surgery  nomogram  prognosis
基金项目:湖北省技术创新 专项（No. 2019A CA132）； 国家重点研发计 划“重大慢性非 传染性疾病防控 研究”重点专项 项目（No. 2017Y FC1310000）； 华中科技大学自 主 创 新 项 目 （No. 2019kfyXK JC075）
作者单位
卢凯，叶晓东，朱遂强 华中科技大学同 济医学院附属同 济医院神经内科 
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中文摘要:
      目的：构建并验证脑出血微创手术患者术后 1 年预后的预测模型。方法：回顾性分析 2012 年 6 月至 2018年12月武汉同济医院行脑出血微创手术治疗患者的临床资料。采用多因素回归分析筛选影响患者预后 的独立危险因素，基于筛选出的独立危险因素构建列线图；采用一致性指数和校准曲线评估列线图的区分能 力和精准度。结果：本研究共纳入435例患者，171例（39.3%）患者预后不良。多因素回归分析提示，年龄、脑 出血病史、入院美国国立卫生院脑卒中量表（NIHSS）评分、血肿体积、残余血肿体积是脑出血微创手术患者预 后的危险因素。基于上述5项危险因素构建预测脑出血患者微创术后预后的列线图并进行内部验证。列线 图预测模型的一致性指数为0.807（95% CI为0.788-0.826），具有良好的区分度和精准度。结论：基于年龄、脑 出血病史、入院NIHSS评分、血肿体积、残余血肿体积的脑出血微创术后预测列线图，能相对准确地预测脑出 血微创手术患者的预后，为患者个体化管理提供依据。
英文摘要:
      To develop and internally validate a model for predicting the 1-year prognosis of intracerebral hemorrhage (ICH) patients after minimally invasive surgery (MIS). Methods: We retrospectively analyzed the clinical data of patients who underwent MIS for ICH evacuation at Tongji Hospital from June 2016 to December 2018. A multivariate regression model was employed to identify the independent risk factors that affect prognosis, and a nomogram was developed based on these factors. The discrimination and accuracy of the model was evaluated by concordance and calibration curve. Results: A total of 435 patients were enrolled，and 171 (39.3%) patients had an unfavorable outcome. Age, previous hemorrhagic stroke, NIHSS score at admission, hematoma volume, and residual hematoma volume were identified as independent predictors of unfavorable outcome in patients after MIS. The discrimination and accuracy of the nomogram created using the above 5 factors were excellent, with a C-index of 0.807 (95%CI: 0.788-0.826). Conclusion: The nomogram based on age, previous hemorrhagic stroke, NIHSS score, hematoma volume, and residual hematoma volume may predict risk of unfavorable outcome in patients after MIS and may provide the basis for individualized disease management.
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