临床神经外科杂志2024，Vol.21Issue(4)：365-370,6.DOI:10.3969/j.issn.1672-7770.2024.04.002
颅脑创伤患者临床输血影响因素分析及预测模型构建
Influencing factors of clinical blood transfusion in patients with traumatic brain injury and construction of prediction model
摘要
Abstract
Objective To create a prediction model for clinical blood transfusion decision-making by analyzing the factors that affect blood transfusion in patients with traumatic brain injury(TBI).Methods The clinical data of 3 579 patients with TBI admitted to the First Affiliated Hospital of Nanchang University from January 1,2015 to June 30,2021 were analyzed retrospectively.The patients were divided into transfusion group and non-transfusion group based on in-hospital red blood cell transfusion.The patients were randomly divided into training set and test set according to the ratio of 7∶3.The clinical information of two groups as well as clinical prognostic outcomes were examined.The risk factors associated with in-hospital blood transfusion were screened using logistic regression to create a nomogram predictive model,and the model's predictive capability was assessed.Results There were differences in basic data,clinical indications and laboratory test indexes between TBI patients with blood transfusion and those without blood transfusion(P<0.05).The in-hospital mortality,complication rate,mechanical ventilation,intensive care unit admission and hospitalization time in the blood transfusion group were significantly higher than those in the non-blood transfusion group(P<0.05).Age≥60 years,heart rate,Glasgow coma score,skull fracture,other fractures,hemorrhagic shock,Hct,INR and Ca were included in the nomogram model.The area under the ROC curve of the nomogram model in the training set and the test set was 0.931(95%CI:0.921-0.941)and 0.920(95%CI:0.902-0.938),and the sensitivity and specificity were 80.0%,88.8%and 78.0%,87.0%,respectively.Conclusions Nomogram prediction model has good performance,which can be used to predict the blood transfusion demand of TBI patients,assist clinicians in blood transfusion decision-making,and improve the success rate of treatment.关键词
创伤性颅脑损伤/临床输血/逻辑回归/列线图/预测模型Key words
traumatic brain injury/blood transfusion/logistic regression/nomogram/predictive model分类
医药卫生引用本文复制引用
刘威,吴承高,刘强,熊伟,乐爱平..颅脑创伤患者临床输血影响因素分析及预测模型构建[J].临床神经外科杂志,2024,21(4):365-370,6.基金项目
江西省重点研发计划项目(20192ACB50014) （20192ACB50014）
