恶性肿瘤患者谵妄发生风险的预测模型研究  

Nomogram prediction model of delirium risk in patients with malignant tumors

作　　者：田甜[1] 景慧[2] 付佳[1] TIAN Tian;JING Hui;FU Jia(First Operating Room,Shengjing Hospital of China Medical University,Shenyang 110004,China;不详)

机构地区：[1]中国医科大学附属盛京医院第一手术室,沈阳110004 [2]中国医科大学附属盛京医院临床技能实践教学中心,沈阳110004

出　　处：《实用医学杂志》2021年第20期2641-2646,共6页The Journal of Practical Medicine

基　　金：辽宁省自然科学基金(编号:2014021092)。

摘　　要：目的分析恶性肿瘤患者发生谵妄的危险因素,构建谵妄发生风险列线图预测模型。方法选取2019年1月至2020年12月中国医科大学附属盛京医院肿瘤内科收治的312例恶性肿瘤患者为研究对象,根据DMS-5诊断标准将患者分为非谵妄组和谵妄组,分析比较两组患者临床资料,经多因素logistic回归分析确定谵妄发生风险独立危险因素,并基于独立危险因素构建恶性肿瘤患者谵妄发生风险列线图预测模型。利用校正曲线和ROC曲线评估列线图预测模型的精确度和区分度。结果纳入分析312例患者中45例患者发生谵妄,谵妄发生率为14.42%。多因素logistic回归分析显示年龄、颅内恶性病变,焦虑、疼痛、匹兹堡睡眠质量指数是恶性肿瘤患者发生谵妄的独立危险因素(P<0.05),基于上述5项独立危险因素构建谵妄发生列线图预测模型,内部验证校正曲线显示预测曲线与实际观察曲线基本吻合,ROC曲线分析显示曲线下面积AUC=0.919。结论本研究构建恶性肿瘤患者谵妄发生风险列线图预测模型具有较好的预测效能,可对恶性肿瘤患者谵妄风险进行早期预测,帮助临床医护人员早期筛查恶性肿瘤患者中谵妄发生高危人群。Objective To analyze the risk factors of delirium in patients with malignant tumors and construct a nomogram prediction model.Methods A total of 312 patients with malignant tumors admitted to the Department of Oncology in Shengjing Hospital of China Medical University from January 2019 to December 2020 were selected.The patients were divided into non-delirium group and delirium group according to the DMS-5 diagnostic criteria.The clinical data of the two groups were analyzed and compared.The independent risk factors for delirium were determined by multivariate logistic regression analysis,which were further utilized to establish the nomogram prediction model of the risk of delirium in patients with malignant tumor.The calibration curve and ROC curve were used to evaluate the accuracy and discrimination of the nomogram prediction model.Results The incidence of delirium was 14.42%(45/312).Multivariate logistic regression analysis showed age,intracranial lesions,anxiety,pain,and Pittsburgh sleep quality index were independent risk factors for delirium in patients with malignant tumors(P<0.05).The prediction nomogram model was constructed based on the independent risk factors mentioned above.In internal validation,calibration curve showed that the prediction curve was basically consistent with the actual observation curve,and ROC curve analysis showed that the area under the curve AUC was 0.919.Conclusion This study constructed a nomogram model to predict the risk of delirium in patients with malignant tumors.It could make early prediction of the risk of delirium in patients with malignant tumors,and help clinical medical staff to early screen the high-risk groups of delirium among patients with malignant tumors.

关 键 词：恶性肿瘤 谵妄 列线图 

分 类 号：R47[医药卫生—护理学]