中国输血杂志2025，Vol.38Issue(4)：537-545,9.DOI:10.13303/j.cjbt.issn.1004-549x.2025.04.012
血液病患者血小板输注无效的预测模型验证
Validation of a predictive model for platelet transfusion refractoriness in patients with hematological diseases
摘要
Abstract
Objective To validate and optimize the platelet transfusion refractoriness(PTR)prediction model for pa-tients with hematological disorders established by our center.Methods The data of patients with hematological diseases who received platelet transfusions from December 2021 to December 2022 were used as the training set,and data from January 2023 to December 2023 as the validation set.The validation set data was used to validate the predictive model constructed on the training set.Relevant risk factors for PTR were collected through literature review and preliminary studies.The pa-tients were divided into effective and ineffective groups according to the corrected count increment(CCI)of platelet counts.Predictive factors were screened using univariate and multivariate logistic regression.The calibration of the model were as-sessed via calibration curves,while discrimination,accuracy,sensitivity,and specificity were evaluated using receiver op-erating characteristic(ROC)curves Clinical utility was further analyzed with decision curve analysis(DCA).Results The Hosmer-Lemeshow(H-L)goodness-of-fit test for the validation set yielded S:P=0.000,indicating that the original model needs optimization.Baseline comparisons and logistic regression identified the number of red blood cell units(RBC-U)and platelet units(PLT-U)transfused as key predictors for the optimized model.The H-L goodness-of-fit test S:P val-ues for the training and validation sets were 0.930 and 0.056,respectively;the ROC areas were 0.793 5 and 0.809 4,specificities 90.95%and 84.21%,sensitivities 59.26%and 70.04%,and accuracies 78.14%and 74.10%,respectively.DCA demonstrated clinical net benefit within a prediction probability threshold range of 0.2-0.8.Conclusion Transfusion volumes of RBC-U and PLT-U were inversely associated with PTR in hematological patients.The resulting PTR prediction model exhibits moderate predictive efficacy and clinical benefit.关键词
血液病/血小板输注无效/模型验证Key words
hematological disease/platelet transfusion refractoriness(PTR)/model validation分类
临床医学引用本文复制引用
黄秀兰,岳姝含,蔡群,卢黎琦,何梦珍,雷乔,刘曹毅,张静薇..血液病患者血小板输注无效的预测模型验证[J].中国输血杂志,2025,38(4):537-545,9.基金项目
成都市科学技术局技术创新研发项目(2024-YF05-00936-SN) （2024-YF05-00936-SN）
