中青年冠心病病人5年内再入院风险预测模型的构建  

Construction of a 5⁃year readmission risk prediction model for young and middle⁃aged patients with coronary heart disease

作　　者：徐亚萍 张蓉 张楚研 王慧 海瑞 杨益[2] XU Yaping;ZHANG Rong;ZHANG Chuyan;WANG Hui;HAI Rui;YANG Yi(School of Nursing,Xinjiang Medical University,Xinjiang 830011 China)

机构地区：[1]新疆医科大学护理学院,新疆830011 [2]新疆医科大学第一附属医院

出　　处：《护理研究》2023年第9期1556-1561,共6页Chinese Nursing Research

基　　金：新疆维吾尔自治区研究生创新项目,编号:XJ2021G230。

摘　　要：目的:探讨中青年冠心病病人再入院的危险因素,构建中青年冠心病病人5年内再入院风险预测模型,并评估其区分度和有效性。方法:选取新疆某三级甲等医院心脏中心2017年1月—2021年12月收治的中青年冠心病病人302例,根据病人5年内是否因冠心病再次入院治疗将其分为再入院组(223例)和未再入院组(79例)。采用Logostic回归分析探讨中青年冠心病病人5年内再入院的影响因素,构建中青年冠心病病人5年内再入院风险预测列线图模型,采用受试者工作特征(ROC)曲线、校正曲线、决策曲线评估该列线图模型预测中青年冠心病5年内再入院风险的区分度及有效性。结果:Logistic回归分析显示,冠脉病变血管数目[OR=3.963,95%CI(1.438,10.919)]、PCI诊疗史[OR=22.567,95%CI(9.692,52.550)]、空腹血糖[OR=1.304,95%CI(1.002,1.697)]是中青年冠心病病人5年内再入院的影响因素。基于多因素Logistic回归分析结果构建中青年冠心病病人5年内再入院风险预测列线图模型。ROC曲线分析结果显示,列线图模型预测中青年冠心病病人5年内再入院的曲线下面积为0.888。H⁃L拟合优度检验结果显示,χ2=7.869,P=0.446。列线图模型预测中青年冠心病病人5年内再入院的实际曲线接近理想曲线。结论:冠脉病变、PCI诊疗史、空腹血糖是中青年冠心病病人5年内再入院的影响因素,且基于上述影响因素构建的中青年冠心病病人5年内再入院风险预测列线图模型具有较好的区分度和有效性,可作为临床早期预测中青年冠心病病人5年内再入院风险的工具。Objective:To explore risk factors of readmissions in young and middle-aged patients with coronary heart disease,to construct a nomogram for predicting the risk of readmission in young and middle⁃aged patients with coronary heart disease within five years,and to evaluate its differentiation and effectiveness.Methods:A total of 302 young and middle⁃aged patients with coronary heart disease admitted to the heart center of a tertiary Grade A hospital in Xinjiang from January 2017 to December 2021 were selected.According to whether the patients were readmitted for coronary heart disease within five years,they were divided into readmitted group(n=223)and non⁃readmitted group(n=79).Logistic regression analysis was used to explore the influencing factors of readmission in young and middle⁃aged patients with coronary heart disease within five years.A nomogram model for predicting the risk of readmission in young and middle⁃aged patients with coronary heart disease within five years was constructed.ROC curve,correction curve,decision curve and nomogram were used to evaluate the differentiation and effectiveness of the nomogram model in predicting the risk of readmission within five years of young and middle-aged patients with coronary heart disease.Result:Logistic regression analysis showed that the number of coronary artery lesions(OR=3.963,95%CI:1.438⁃10.919),PCI diagnosis and treatment history(OR=22.567,95%CI:9.692-52.550),fasting blood glucose(OR=1.304,95%CI:1.002⁃1.697).Based on the results of Logistic regression analysis,a nomogram model for predicting the risk of readmission in young and middle⁃aged patients with coronary heart disease within five years was constructed.ROC curve analysis showed that the AUC of nomogram model was 0.888.H⁃L goodness of fit test showed thatχ2=7.869,P=0.446.The actual curve of nomogram model predicting the readmission of young and middle⁃aged patients with coronary heart disease within five years was close to the ideal curve.Conclusion:Coronary artery lesion,PCI his

关 键 词：冠心病 中青年 再入院 影响因素 预测模型 列线图 

分 类 号：R541.4[医药卫生—心血管疾病]