老年肺癌患者衰弱风险预测模型的构建及验证  

Construction and verification of frailty risk prediction model in elderly lung cancer patients

作　　者：徐萌萌 王晓兰 陈柔迪 Xu Mengmeng;Wang Xiaolan;Chen Roudi(Department of Thoracic Surgery,People's Hospital of Hai'an,Hai'an 226600,Jiangsu,China;Department of Operating Room,Zhongshan Hospital Affiliated to Fudan University,Shanghai 200032,China)

机构地区：[1]海安市人民医院胸外科,江苏海安226600 [2]复旦大学附属中山医院手术室,上海200032

出　　处：《肿瘤代谢与营养电子杂志》2024年第6期840-846,共7页Electronic Journal of Metabolism and Nutrition of Cancer

基　　金：2021年度江苏省老年科研项目(LK2021047)。

摘　　要：目的探讨衰弱在老年肺癌患者中的发生现状及其影响因素,构建衰弱预测模型并完成验证。方法便利抽样选取海安市人民医院于2022年1月至2024年3月收治的500例肺癌患者作为研究对象,分析衰弱现状及其存在的影响因素,利用回归分析构建衰弱风险预测模型,使用列线图展示模型并完成验证。结果建模组纳入350例老年肺癌患者,年龄61~79岁,平均(68.22±7.25)岁;女性121例(34.57%),男性229例(65.43%)。纳入的350例老年肺癌患者中,有123例发生衰弱,发生率为35.14%。单因素分析结果:年龄、Charson共病指数、营养风险、病程时间、体质指数(BMI)、高血红蛋白、D-二聚体、白蛋白、抑郁及癌性疲乏成为老年肺癌患者衰弱的独立危险因素(P<0.05)。多因素分析结果:年龄、Charson共病指数、病程时间、D-二聚体、抑郁及癌性疲乏成为老年肺癌患者衰弱的危险因素(P<0.05),血红蛋白、白蛋白、BMI、无营养风险成为老年肺癌患者衰弱的保护性因素(P<0.05)。验证组150例老年肺癌患者衰弱曲线下面积(AUC)为0.842(95%CI=0.802~0.886),敏感度为83.5%,特异度为73.8%。结论老年肺癌患者衰弱发生受到年龄、Charson共病指数、营养风险、病程时间、D-二聚体、白蛋白、抑郁及癌性疲乏等的影响。未来应开展轨迹研究,对老年肺癌患者衰弱预测模型进行优化,建立动态列线图模型,为临床动态预测提供依据,以期减少衰弱和改善患者生存质量。Objective To investigate the occurrence and influencing factors of frailty in elderly lung cancer patients,establish a frailty prediction model and verify it.Method In this study,500 patients with lung cancer admitted to our hospital during the period from January 2022 to March 2024 were selected as research objects:The frailty status and influencing factors were analyzed statistically.Regression analysis was used to construct frailty risk prediction model,and the model was displayed and verified by column graph.Result In the modeling group of this study,350 elderly lung cancer patients,aged 61-79 years old,with an average age of(68.22±7.25)years old,including 121 females(34.57%)and 229 males(65.43%),participated.Among 350 elderly patients with lung cancer,123 had frailty(35.14%).Univariate analysis showed that age,Charson comorbidity index,nutritional status,duration of disease,body mass index(BMI),hemoglobin,D-dimer,albumin,depression and cancer fatigue were the independent risk factors for fadility in elderly lung cancer patients(P<0.05).Result of multi-factor analysis:Age,Charson comorbidity index,duration of disease,D-dimer,depression and cancer fatigue were the risk factors for frailty in elderly lung cancer patients(P<0.05),hemoglobin,albumin,BMI,nutritional status were the protective factors for frailty in elderly lung cancer patients(P<0.05).In the verification group,AUC was 0.842(95%CI=0.802-0.886),sensitivity was 83.5%,and specificity was 73.8%.Conclusion This study established a risk prediction model for frailty in elderly lung cancer patients.Frailty in elderly lung cancer patients is affected by age,Charson comorbidity index,nutritional status,duration of disease,D-dimer,albumin,depression and cancerous fatigue.In the future,trajectory studies should be carried out to optimize the prediction model and establish a dynamic nomogram model to provide a reliable tool for clinical nurses to dynamically predict the frailty of elderly patients with lung cancer,with a view to reducing frailty.

关 键 词：肺癌 衰弱 列线图 营养风险 预测模型 老年患者 风险因素 风险预测 

分 类 号：R73[医药卫生—肿瘤]