广东医学2024，Vol.45Issue(12)：1594-1600,7.DOI:10.13820/j.cnki.gdyx.20242150
极早产儿中/重度支气管肺发育不良发生风险的预测模型构建
Development of a predictive nomogram for the risk of moderate-to-severe bronchopulmonary dysplasia in ex-tremely preterm infants
摘要
Abstract
Objective To identify risk factors for moderate-to-severe bronchopulmonary dysplasia(BPD)in extremely preterm infants born at less than 32 weeks'gestational age and to develop an early predictive nomogram model.Methods A retrospective analysis was conducted on extremely preterm infants born between January 2019 and December 2020 at the Third Affiliated Hospital of Guangzhou Medical University who developed BPD.Perinatal data and clinical in-formation during hospitalization were collected,and risk factors for moderate-to-severe BPD were identified using logis-tic regression analysis.Based on these findings,a nomogram prediction model was constructed and internally validated u-sing the Bootstrap method.An external validation cohort was selected from infants born between January 2021 and June 2021 meeting the same inclusion and exclusion criteria.Both the training and validation groups were used to assess the model's discrimination and accuracy.Results A total of 266 extremely preterm infants with BPD were included in the model development cohort,comprising 189 cases of mild BPD(71.1％)and 77 cases of moderate-to-severe BPD(28.9％).Multivariate logistic regression analysis indicated that preeclampsia,pneumonia,duration of invasive ventila-tion,and hemodynamically significant patent ductus arteriosus(hsPDA)were significant risk factors for moderate-to-severe BPD(P＜0.05).The nomogram model constructed using these four factors demonstrated an area under the curve(AUC)of 0.810(95％CI:0.750-0.870)in the model development cohort and 0.900(95％CI:0.826-0.975)in the validation cohort,with calibration curves close to the ideal diagonal line,indicating good calibration.Conclusion Preeclampsia,pneumonia,duration of invasive ventilation,and hsPDA are independent risk factors for moderate-to-se-vere BPD in extremely preterm infants.The nomogram model combining these four indicators demonstrates good predictive value,aiding in early identification of infants at risk of moderate-to-severe BPD to improve prevention and management outcomes.关键词
极早产儿,支气管肺发育不良/影响因素/预测效能Key words
extremely preterm infants/bronchopulmonary dysplasia/risk factors/predictive model分类
医药卫生引用本文复制引用
李彩环,古健,樊雨薇,范斯潆,李苑,钟鑫琪,黄为民..极早产儿中/重度支气管肺发育不良发生风险的预测模型构建[J].广东医学,2024,45(12):1594-1600,7.基金项目
广东省自然科学基金项目(2022A1515010289) （2022A1515010289）
广州市科技计划局基础与应用基础研究项目(2024A03J1163) （2024A03J1163）
