中国输血杂志2023，Vol.36Issue(11)：990-994,5.DOI:10.13303/j.cjbt.issn.1004-549x.2023.11.004
重度颅脑创伤患者临床输血预测模型构建
Construction of blood transfusion prediction model for patients with severe traumatic brain injury
摘要
Abstract
Objective To construct a blood transfusion prediction model for patients with severe traumatic brain injury(TBI),in order to predict the risk of blood transfusion and guide blood transfusion decision-making.Methods The clinical data of 756 patients with severe TBI admitted to the hospital from January 1,2015 to June 30,2021 were retrospectively ana-lyzed.According to whether the patients were transfused with red blood cells after admission,the patients were divided into blood transfusion group(n=354)and non-blood transfusion group(n=402).The basic clinical data and prognostic indicators of the two groups were compared.Logistic regression algorithm was used to screen the risk factors related to blood transfusion in hospital to establish a nomogram prediction model,and the performance of the model was evaluated.Results No significant differences were noticed in gender,age,body temperature,cause of injury,ABO blood group,Rh blood group,serum Na and K concentrations between the two groups(P＞0.05).Significant differences were found in Glasgow coma score(GCS),heart rate(HR),systolic blood pressure(SP),diastolic blood pressure(DP),shock index(SI),respiratory rate(RR),clinical diagnosis,treatment,hemoglobin concentration(Hb),hematocrit(Hct),platelet count(Plt)and coagula-tion function between the two groups(P＜0.05).The length of stay,complication rate,ventilator utilization rate,ICU admis-sion rate and 90-day readmission rate in the blood transfusion group were significantly higher than those in the non-blood transfusion group(P＜0.05).However,there was no significant difference in in-hospital mortality between the two groups(P＞0.05).Multivariate logistic regression analysis showed that surgical treatment,skull fracture,hemorrhagic shock,de-creased Plt,decreased Hct and increased INR were independent risk factors for blood transfusion.A nomogram prediction model was constructed and the area under the ROC curve of the training set and the test set was 0.819(95% CI:0.784-0.854)and 0.866(95% CI:0.818-0.910),respectively,which had good predictive performance.Conclusion Surgical treatment,skull fracture,hemorrhagic shock,decreased Plt,decreased Hct and increased INR are independent risk factors for blood transfusion in adult patients with severe traumatic brain injury.The nomogram prediction model can better predict the blood transfusion demand of TBI patients and has high application value.关键词
颅脑创伤/临床输血/列线图预测模型/Logistic回归Key words
traumatic brain injury/blood transfusion/nomogram prediction model/logistic regression分类
医药卫生引用本文复制引用
吴承高,刘强,熊伟,乐爱平,刘威..重度颅脑创伤患者临床输血预测模型构建[J].中国输血杂志,2023,36(11):990-994,5.基金项目
江西省重点研发计划项目(20192ACB50014) （20192ACB50014）
江西省卫生健康委员会科技计划项目(202130327) （202130327）
