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- Title
结合炎症反应指数的Nomogram模型对aSAH患者预后预测的价值.
- Authors
张鹏; 李育平; 王晓东; 汤灿; 朱磊; 万志强; 黄健楠; 张恒柱
- Abstract
Objective To investigate the prognostic value of Nomogram model constructed by combining inflammatory response index with other clinical indicators in patients with aneurismal subarachnoid hemorrhage(aSAH). Methods The clinical data of 178 patients with aSAH treated with surgery from January 2015 to December 2017 at Subei People Hospital were analyzed retrospectively, including neutrophil-to-lymphocyte ratio(NLR), derived neutrophil-to-lymphocyte ratio(dNLR), platelet-to-lymphocyte ratio(PLR), monocyte-to-lymphocyte ratio(MLR), prognostic nutritional index(PNI) and systemic inflammation response index(SIRI). The cases were divided into two groups based on the GOS(Glasgow outcome scale) score as good prognosis group and poor prognosis group. Univariate analysis and multivariate analysis were used to analyze the correlation between inflammation response index and prognosis, and to identify the risk factors influencing prognosis. Meanwhile, each factor was scored by Nomogram method to construct the prediction model. The receiver operating characteristic curve(ROC) was drawn to evaluate the predictive value of inflammation response index and Nomogram model in patients with aSAH. Results In this cohorts, 131 patients(73.6%) had good prognosis, while 47 (26.4%) had poor prognosis. The univariate analysis revealed significant differences in the smoking, hypertension, admission Hunt-Hess grade, modified Fisher grade, cerebral vasospasm, neutrophil and monocyte count, NLR, dNLR, MLR, SIRI between 2 groups(P<0.05-0.001). Multivariate logistic regression analysis showed that smoking(P=0.006), hypertension(P<0.001), admission Hunt-Hess grade(P=0.016), modified Fisher grade(P=0.018), cerebral vasospasm(P=0.017), and SIRI(P=0.043) were independent risk factors influencing the outcome. These risk factors were incorporated into the Nomogram. The consistency index of the model was good(C-index=0.782, P<0.01). ROC curve analysis showed that the model combining the SIRI and other prognostic factors(AUC=0.836, 95% CI:0.760-0.911, P<0.001) showed more favorable discriminative ability than the model without the SIRI(AUC=0.798, 95% CI:0.722-0.875, P<0.001) and the model using the SIRI only(AUC=0.671, 95% CI:0.579-0.763, P=0.001). Conclusions The inflammation response index is closely correlated with the prognosis of patients with aSAH. SIRI is an independent risk factor of affecting the outcome with aSAH after surgical treatment and it has some values to predict prognosis. A nomogram combining the SIRI can more accurately predict the prognosis of aSAH.
- Publication
Journal of Clinical Neurosurgery / Linchuang Shenjingwaike Zazhi, 2020, Vol 17, Issue 2, p216
- ISSN
1672-7770
- Publication type
Article
- DOI
10.3969/j.issn.1672-7770.2020.02.021