摘要
Abstract
Objective To construct and validate a prediction model for re-hemorrhage after puncture and drainage in elderly patients with hypertensive intracerebral hemorrhage(HICH)based on CT plain scan image texture and neurotrophic factors.Methods A total of 160 elderly patients with HICH admitted to Rugao People's Hospital from January 2018 to December 2023 were prospectively selected and randomly divided into a training set(112 cases)and a validation set(48 cases)in a 7:3 ratio.All patients underwent puncture and drainage surgery,and were followed for re-hemorrhage within 48 hours postoperatively.Factors influencing re-hemorrhage after puncture and drainage surgery were analyzed.A prediction model for re-hemorrhage after puncture and drainage surgery in elderly patients with HICH was established,followed by validation and evaluation of its predictive performance.Results In the training set,21 patients experienced postoperative re-hemorrhage,compared to 11 in the validation set.Logistic regression analysis showed intracerebral hemorrhage volume(OR=4.491,95%CI=1.848-10.914),skewness value(OR=4.035,95%CI=1.660-9.806),and brain-derived neurotrophic factor(BDNF)level(OR=3.483,95%CI=1.433-8.466)were factors influencing re-hemorrhage after puncture and drainage surgery in elderly HICH patients(P<0.05).A nomogram prediction model was established using the above influencing factors as variables.The model validation yielded a C-index of 0.799(95%CI=0.741-0.811).The calibration curve demonstrated good agreement with the ideal line(χ2=0.289,P>0.05).ROC curve analysis for the training set showed that the nomogram predicted re-hemorrhage after puncture and drainage surgery in elderly HICH patients with a sensitivity of 76.19%,a specificity of 89.01%,and an AUC of 0.854(95%CI=0.772-0.935).In the validation set,the model achieved a sensitivity of 83.33%,a specificity of 85.71%,and an AUC of 0.869(95%CI=0.789-0.941).Conclusion Intracerebral hemorrhage volume,skewness value,and BDNF level are influencing factors for re-hemorrhage after puncture and drainage surgery in elderly patients with HICH.The prediction model for re-hemorrhage after puncture and drainage surgery in elderly patients with HICH,developed based on CT plain scan image texture and neurotrophic factors,demonstrates good predictive performance.关键词
高血压脑出血/穿刺引流术/再出血/列线图模型Key words
Hypertensive cerebral hemorrhage/Puncture and drainage/Re-hemorrhage/Nomogram model
