炎性肠病患者衰弱风险预测模型的构建及评价

doi:10.16352/j.issn.1001-6325.2023.07.1127

基础医学与临床 ›› 2023, Vol. 43 ›› Issue (7): 1127-1133.doi: 10.16352/j.issn.1001-6325.2023.07.1127

炎性肠病患者衰弱风险预测模型的构建及评价

尤丽丽¹, 杨丽潇¹, 王思瑶¹, 钱娜¹, 卢敏¹, 宋萌¹, 关玉霞^2,*

1.中国医学科学院北京协和医学院北京协和医院消化内科 ,北京 100730;
2.中国医学科学院北京协和医学院北京协和医院肾内科, 北京 100730

收稿日期:2023-04-07 修回日期:2023-05-23 出版日期:2023-07-05 发布日期:2023-07-05
通讯作者: ^*guan_yuxia@sina.com
基金资助:
北京协和医学院“中央高校基本科研业务费”(3332021005); 中央高水平医院临床科研业务费资助(2022-PUMCH-B-031)

Construction and validation of a risk prediction model for frailty in patients with inflammatory bowel disease

YOU Lili¹, YANG Lixiao¹, WANG Siyao¹, QIAN Na¹, LU Min¹, SONG Meng¹, GUAN Yuxia^2,*

1. Department of Gastroenterology, Peking Union Medical College Hospital, CAMS & PUMC,Beijing 100730, China;
2. Department of Nephrology, Peking Union Medical College Hospital, CAMS & PUMC,Beijing 100730, China;

Received:2023-04-07 Revised:2023-05-23 Online:2023-07-05 Published:2023-07-05

摘要/Abstract

摘要： 目的构建炎性肠病患者衰弱风险预测模型并验证其预测效果。方法采用便利抽样法,选取2021年7月至2021年11月在北京协和医院消化内科住院治疗的360例炎性肠病患者为样本,根据衰弱筛查量表(FS)评估结果分为衰弱和无衰弱2类,收集并比较2类患者人口学因素、疾病相关因素等的差异。使用随机数字法以8∶2的比例分为建模组和验证组,采用Logistic 回归分析建立风险预测模型,使用Hosmer-Lemeshow χ² 检验预测模型拟合效果,并绘制受试者工作特征(ROC)曲线,计算ROC曲线下面积(AUC)和约登指数,评估预测模型的区分能力。结果炎性肠病患者衰弱发生率为16.6%。年龄大(OR=1.041)、消瘦(OR=10.135)、每月锻炼数次(OR=0.345)、疾病类型为溃疡性结肠炎(OR=2.952)、生活质量(OR=0.979)、家庭关怀度(OR=1.629)、抑郁(OR=1.194)和睡眠障碍(OR=1.158)是其独立影响因素(P<0.05)。Hosmer-Lemeshow检验结果显示,χ²=1.594,P=0.991,AUC=0.934(95% CI:0.901~0.966),最大约登指数为0.728,最佳临界值为0.128,敏感度为92.0%,特异度为81.8%。内部验证结果显示,该模型的灵敏度为88.9%,特异度为72.6%,正确率为91.55%。结论本研究建立的衰弱风险预测模型的预测效果良好,可为临床评估炎性肠病患者衰弱发生风险提供参考。

关键词: 炎性肠病, 溃疡性结肠炎, 克罗恩病, 衰弱, 风险预测

Abstract: Objective To establish a risk prediction model for frailty in patients with inflammatory bowel disease and verify its prediction effect. Methods A classic sampling method was used to collect samples from 360 patients with inflammatory bowel disease who were hospitalized in the Department of Gastroenterology of Peking Union Medical College Hospital from July 2021 to November 2021. According to the evaluation results of the FRAIL Scale (FS), patients were divided into two group: frail group and non-frail group. The differences of demographic factors and disease related factors between the two categories of patients were compared. Randomized number method was used to divide the model group and verification group at a ratio of 8∶2. Logistic regression analysis was used to establish a risk prediction model. Hosmer-Lemeshow χ² was used to test the prediction model fitting effect, and receiver operator characteristic curve (ROC curve) was drawn. Area under ROC curve (AUC) and Youden index were calculated to evaluate the differentiation ability of the prediction model. Results The incidence of frailty in patients with inflammatory bowel disease was 16.6%. Age (OR=1.041), emaciation (OR=10.135), several times of exercise per month (OR=0.345), ulcerative colitis (OR=2.952), quality of life (OR=0.979), family care index (OR=1.629), depression (OR=1.194) and sleep disorders (OR=1.158) were independent influencing factors (P<0.05). The results of Hosmer-Lemeshow test showed that χ²=1.594, P=0.991, AUC=0.934 (95% confidence interval, 95% CI: 0.901~0.966), the maximum Youden index was 0.728, the optimal critical value was 0.128, the sensitivity was 92.0%, and the specificity was 81.8%. The validation results show that the sensitivity of the model is 88.9%, the specificity is 72.6%, and the accuracy is 91.55%. Conclusions The prediction effect of the risk prediction model is good, which can provide a reference for clinical evaluation of the frail risk of patients with inflammatory bowel disease.

Key words: inflammatory bowel disease, ulcerative colitis, Crohn’s disease, frailty, risk prediction

中图分类号:

R574

尤丽丽, 杨丽潇, 王思瑶, 钱娜, 卢敏, 宋萌, 关玉霞. 炎性肠病患者衰弱风险预测模型的构建及评价[J]. 基础医学与临床, 2023, 43(7): 1127-1133.

YOU Lili, YANG Lixiao, WANG Siyao, QIAN Na, LU Min, SONG Meng, GUAN Yuxia. Construction and validation of a risk prediction model for frailty in patients with inflammatory bowel disease[J]. Basic & Clinical Medicine, 2023, 43(7): 1127-1133.

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炎性肠病患者衰弱风险预测模型的构建及评价

Construction and validation of a risk prediction model for frailty in patients with inflammatory bowel disease

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