中华脑科疾病与康复杂志（电子版）2023，Vol.13Issue(6)：321-326,6.DOI:10.3877/cma.j.issn.2095-123X.2023.06.001
开发和验证预测脑肿瘤术后消化道出血的列线图:单中心研究
Development and validation of a novel nomogram for predicting gastrointestinal bleeding after brain tumor surgery:a single-center study
摘要
Abstract
Objective To construct a nomogram for accurately predict the possibility of postoperative gastrointestinal bleeding in brain tumor patients.Methods Patients who underwent brain tumor resection at the Neurosurgery Department of Union Hospital,Tongji Medical College,Huazhong University of Science and Technology from January to December 2021 were selected as the research subjects.According to the 3∶1 stratified random sampling principle,the patients were divided into a training set and a testing set.The patients of testing set were divided into two groups based on whether they experienced gastrointestinal bleeding during postoperative hospitalization:the gastrointestinal bleeding group and the non-gastrointestinal bleeding group.Differential analysis and multivariate Logistic regression analysis were used to study the independent influencing factors affecting secondary gastrointestinal bleeding after brain tumor surgery.A clinical prediction model for secondary gastrointestinal bleeding after brain tumor surgery was constructed,and the model is presented as a nomogram.The performance of clinical models evaluated through calibration curves,clinical validity,and internal test sets.Results A total of 400 patients with brain tumors were included,with 300 in the training set.Among them,24 patients had gastrointestinal bleeding after brain tumor surgery(gastrointestinal bleeding group),and 276 patients did not have gastrointestinal bleeding(non-gastrointestinal bleeding group);There were 100 cases in the testing set,including 8 cases of gastrointestinal bleeding and 92 cases without gastrointestinal bleeding.The age,tumor location,history of gastrointestinal diseases,history of coronary heart disease,history of non-steroidal drug use,history of alcohol consumption,and surgical time of the two groups of patients were compared,and the differences were statistically significant(P＜0.05).The results of multivariate Logistic regression analysis showed that age,history of non-steroidal drug use,tumor location,and operation time were independent influencing factors for postoperative gastrointestinal bleeding in brain tumor patients.Based on this,a nomogram model was constructed.The model showed good prediction and stability performance,with the AUC value of 0.817 in the training set and 0.806 in the testing set,respectively.In addition,the calibration curve confirmed that the nomogram fits very well for the real results.Conclusion A nomogram constructed based on factors such as age,history of non-steroidal drug use,tumor location,and surgical time can easily and effectively predict postoperative gastrointestinal bleeding in patients with brain tumors,providing a basis for active prevention of postoperative gastrointestinal bleeding in patients with brain tumors.关键词
脑肿瘤/消化道出血/影响因素/列线图/预测模型Key words
Brain tumor/Gastrointestinal bleeding/Influencing factors/Nomogram/Predictive model引用本文复制引用
黄利军,熊志勇,李丹凤..开发和验证预测脑肿瘤术后消化道出血的列线图:单中心研究[J].中华脑科疾病与康复杂志（电子版）,2023,13(6):321-326,6.基金项目
Youth Science Foundation Project of National Natural Science Foundation of China(82103225)国家自然科学基金青年科学基金项目(82103225) （82103225）
