老年人根面龋相关危险因素分析及列线图预测模型构建  

Analysis of risk factors related to root caries in the elderly and construction of a nomogram prediction model

作　　者：胡硕红 郑学彬 李富杰 HU Shuo-hong;ZHENG Xue-bin;LI Fu-jie(Haikou Truditional Chinese Medicine Hospital,Hainan Haikou 570100,China)

机构地区：[1]海口市中医医院,海南海口570100

出　　处：《临床口腔医学杂志》2022年第12期721-724,共4页Journal of Clinical Stomatology

基　　金：海南省卫生计生行业科研项目(编号:18A200152)。

摘　　要：目的:分析老年人发生根面龋的相关危险因素并构建列线图预测模型。方法:选取2019年9月~2021年9月来我院口腔科就诊的232例60岁以上老年患者为研究对象,其中64例根面龋患者为研究组,其他168例患者为对照组。收集两组患者的临床资料,分析发生根面龋的相关因素;绘制受试者工作特征(ROC)曲线,分析计量指标对根面龋发病的预测价值;Logistic多元回归模型分析影响根面龋发病的危险因素;R语言软件4.0“rms”包构建预测根面龋发病的列线图模型,校正曲线对列线图模型进行内部验证,决策曲线对列线图模型进行临床预测效能评估。结果:与对照组相比,研究组患者年龄较大、食物嵌塞及牙龈退缩比例较高、刷牙频率较低、菌斑指数较高(P<0.05)。年龄、刷牙频率、菌斑指数的AUC分别为0.864、0.853、0.810,最佳截断值分别为66岁、1次、1分。年龄、食物嵌塞、牙龈退缩、刷牙频率、菌斑指数是老年人根面龋的独立危险因素。内部验证结果显示,列线图模型预测老年人根面龋发生的一致性指数(C-index,C指数)为0.783(95%CI 0.634~0.826),校准曲线趋于理想曲线。列线图模型预测老年人根面龋发生的阈值>0.17,列线图模型提供临床净收益,并且列线图模型临床净收益均高于年龄、食物嵌塞、牙龈退缩、刷牙频率、菌斑指数。结论:基于年龄、食物嵌塞、牙龈退缩、刷牙频率、菌斑指数构建的预测老年人根面龋发生的列线图模型,有助于老年患者早期筛查根面龋的发病情况,具有重要的临床应用价值。Objective:To analyze the related risk factors of root caries in the elderly and build a nomogram prediction model.Methods:A total of 232 elderly patients over 60 years old of our hospital from September 2019 to September 2021 were selected as the research objects,of which 64 patients with root caries were the research group,and the other 168 patients were the control group.The clinical data of the two groups of patients were collected,and the related factors of root caries were analyzed.Receiver operating characteristic(ROC)curves were drawn to analyze the predictive value of measurement indicators on the incidence of root caries.Logistic multiple regression model was used to analyze the influence of root caries incidence.The R language software 4.0“rms”package was used to construct the column line graph model for predicting the onset of root surface caries,the calibration curve was used to internally validate the column line graph model,and the decision curve was used to evaluate the clinical prediction performance of the column line graph model.Results:Compared with the control group,the research group had older age,higher proportion of food impaction and gingival recession,lower frequency of tooth brushing,and higher plaque index(P<0.05).The AUCs of age,brushing frequency,and plaque index were 0.864,0.853,and 0.810,respectively,and the optimal cut-off values were 66 years,1 time,and 1,respectively.Age,food impaction,gingival recession,brushing frequency,and plaque index were independent risk factors for root caries in the elderly.The internal validation results showed that the C-index of the nomogram model for predicting the occurrence of root caries in the elderly was 0.783(95%CI 0.634~0.826),and the calibration curve tended to an ideal curve.The threshold value of the nomogram model for predicting the occurrence of root caries in the elderly was greater than 0.17.The nomogram model provide a net clinical benefit,and the net clinical benefit of the nomogram model was higher than that of age,food impaction

关 键 词：老年人 根面龋 风险因素 列线图预测模型 

分 类 号：R781.1[医药卫生—口腔医学] R781.1[医药卫生—临床医学]