蛛网膜下腔出血院内病死率的预测模型

A risk model to predict the in-hospital mortality of subarachnoid hemorrhage

摘要

目的  蛛网膜下腔出血是一种很严重的疾病，有着较高的致死率和致残率。本研究旨在研发一种模型预测蛛网膜下腔出血的院内病死率。方法  本研究数据来自于2014年至2018年就诊于北京大学10所附属医院的患者的相关资料，最终纳入797例诊断为蛛网膜下腔出血的患者。采用单变量和多变量Logistic回归，探究影响蛛网膜下腔出血预后的影响因素，用列线图来预测院内病死率。结果  在纳入的患者中，院内病死率为7.53%。影响因素包括动脉瘤、心脏病、脑疝、脑内血肿、昏迷、肺部感染、呼吸衰竭和肺炎（P值均<0.05）。预测模型的曲线下面积为0.860 (95%CI：0.809~0.911)。结论  本研究构建了一个能够预测蛛网膜下腔患者的院内病死率的模型。

Abstract

Objective  Subarachnoid hemorrhage is a severe disease with high mortality and disability rate. The aim of this study is to develop a model to predict the in-hospital mortality of subarachnoid hemorrhage. Methods  Seven hundred and ninty-seven patients with subarachnoid hemorrhage are extracted from 10 hospitals affiliated to Peking University during a 5-year period (2014-2018). A univariate Logistic regression and a multivariate Logistic regression are used to find the predictive factors for subarachnoid hemorrhage. A nomogram was constructed to predict the mortality. Results  Of the included patients, the mortality rate is 7.53%. The predictors are aneurysm, heart disease, brain herniation, intracerebral hematoma, coma, pulmonary infection, respiratory failure and pneumonia (P<0.05). The area under the curve of the nomogram is 0.860 (95%CI：0.809-0.911). Conclusion  An accurate nomogram is developed to predict the in-hospital mortality of patients with subarachnoid hemorrhage. It will help reduce the mortality rates.

关键词

蛛网膜下腔出血 / 列线图 / 院内病死率 / 风险模型

Key words

subarachnoid hemorrhage / nomogram / hospital mortality / risk model