实用医学杂志2025，Vol.41Issue(4)：553-560,8.DOI:10.3969/j.issn.1006-5725.2025.04.014
基于多中心的儿童颅脑创伤患者临床输血影响因素分析及预测模型构建
Analysis of influencing factors of blood transfusion in children with traumatic brain injury and construc-tion of prediction model:A multi-center retrospective study
摘要
Abstract
Objective To develop a predictive model for guiding blood transfusion decisions in pediatric patients with traumatic brain injury(TBI)by identifying and analyzing key factors that influence blood transfusion requirements.Methods A retrospective analysis was conducted on the clinical data of 1,535 pediatric patients with TBI admitted to four medical institutions from January 1,2015,to December 31,2022.Patients were divided into two groups:those who received red blood cell transfusions during hospitalization and those who did not.Comparative analyses were performed on demographic,clinical,and laboratory data between these two groups.Logistic regression analysis was used to identify risk factors associated with in-hospital blood transfusion,and a predictive model was developed using a nomogram.The performance of this model was evaluated using a receiver operating characteristic(ROC)curve.Results Significant differences were observed between the blood transfusion and non-blood transfusion groups in terms of baseline demographics,clinical indicators,and laboratory test results(all P<0.05).Patients in the blood transfusion group exhibited significantly higher in-hospital mortality,compli-cation rates,use of mechanical ventilation,ICU admission rates,and length of stay compared to those in the non-blood transfusion group(all P<0.05).Multivariate logistic regression analysis identified heart rate,presence of other fractures,treatment methods,hemoglobin(Hb),platelet count(Plt),activated partial thromboplastin time(APTT),and D-dimer levels as independent risk factors for blood transfusion in TBI patients.The area under the ROC curve for the blood transfusion prediction model,based on these independent risk factors,was 0.95(95%CI:0.94～0.97),indicating excellent predictive accuracy.Calibration and decision curves further validated the robust-ness and reliability of the model's predictive capacity.Conclusions Heart rate,presence of other fractures,treatment methods,Hb,Plt count,APTT,and D-dimer levels serve as independent risk factors for blood transfusion in TBI patients.The prediction model developed based on these factors demonstrates excellent predictive performance,thereby guiding clinicians in making informed blood transfusion decisions and enhancing the success rate of patient outcomes.关键词
创伤性颅脑损伤/临床输血/logistic回归/列线图/儿童Key words
traumatic brain injury/blood transfusion/logistic regression/nomogram/child分类
医药卫生引用本文复制引用
刘威,熊伟,吴承高,乐爱平,侯君,唐龙泉,周鹏,钟艳,罗沁妍,况小雨,刘华,熊紫清..基于多中心的儿童颅脑创伤患者临床输血影响因素分析及预测模型构建[J].实用医学杂志,2025,41(4):553-560,8.基金项目
江西省重点研发计划项目(编号:20192ACB50014) （编号:20192ACB50014）
江西省科技创新平台项目(编号:20212BCD42006) （编号:20212BCD42006）
