[1]疏义平,谢玉环,杨新宇,等.颅内肿瘤术后早期癫痫风险预测模型的构建和评价[J].中国临床神经外科杂志,2022,27(11):898-901.[doi:10.13798/j.issn.1009-153X.2022.11.006]
　SHU Yi-ping,XIE Yu-huan,YANG Xin-yu,et al.Establishment and evaluation of a nomogram model for predicting early postoperative seizures in patients undergoing intracranial tumor surgery[J].,2022,27(11):898-901.[doi:10.13798/j.issn.1009-153X.2022.11.006]
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颅内肿瘤术后早期癫痫风险预测模型的构建和评价()
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《中国临床神经外科杂志》[ISSN:1009-153X/CN:42-1603/TN]

卷:
27
期数:
2022年11期
页码:
898-901
栏目:
论著
出版日期:
2022-11-30

文章信息/Info

Title:
Establishment and evaluation of a nomogram model for predicting early postoperative seizures in patients undergoing intracranial tumor surgery
文章编号:
1009-153X（2022）11-0898-04
作者:
疏义平; 谢玉环; 杨新宇; 程旭; 叶雷; 赵梅
230062 合肥，安徽医科大学护理学院（疏义平、杨新宇、程旭、赵梅）；230022 合肥，安徽医科大学第一附属医院神经外科（疏义平、谢玉环、叶雷）
Author(s):
SHU Yi-ping1; 2;  XIE Yu-huan2;  YANG Xin-yu1;  CHENG Xu1;  YE Lei2;  ZHAO Mei1
1. School of Nursing, Anhui Medical University, Hefei 230062, China; 2. Department of Neurosurgery, First Affiliated Hospital of Anhui Medical University, Hefei 230022, China
关键词:
颅脑肿瘤; 术后早期癫痫; 影响因素; 风险预测; 列线图
Keywords:
Intracranial tumor;  Early postoperative seizures;  Risk factor;  Predictive model;  Nomogram
分类号:
R739.41;R742.1
DOI:
10.13798/j.issn.1009-153X.2022.11.006
文献标志码:
A
摘要:
目的 构建颅内肿瘤术后早期癫痫（EPS）风险预测模型并评价其预测效率、区分度、校准度及临床适用性。方法 回顾性分析2019年9月至2021年4月手术治疗的402例颅内肿瘤的临床资料。术后1周根据临床表现和脑电图诊断EPS。采用多因素logistic回归模型分析EPS的独立预测因素，采用R软件构建列线图预测模型并进行内部验证及评价。结果 402例中，42例术后1周发生EPS，发生率为10.45%。多因素logistic回归分析显示，术前癫痫病史、肿瘤未全切除、肿瘤位于额叶、术区水肿、术区出血是颅内肿瘤术后发生EPS的独立危险因素（P<0.05），构建的列线图预测模型Harrell’s C-index为0.821（95% CI 0.754~0.888），预测灵敏度为0.857、特异度为0.625，内部验证后列线图的ROC曲线下面积为0.831（95% CI 0.765~0.886）。结论 颅内肿瘤发生EPS的影响因素很多，根据术前癫痫病史、肿瘤切除程度和肿瘤位置、术区水肿、术区出血构建的列线图预测模型具有良好的校准度和区分度，具有一定的临床适用性，能为临床提供参考依据。
Abstract:
Objective To establish a nomogram model for predicting early postoperative seizures (EPS) in the patients with intracranial tumor after surgery, and to evaluate its efficiency, differentiation, and calibration for prediction of EPS and its clinical applicability. Methods The clinical data of 402 patients with intracranial tumor who underwent surgery from September 2019 to April 2021 were retrospectively analyzed. One week after surgery, EPS was diagnosed according to clinical manifestations and EEG. Multivariate logistic regression model was used to analyze the independent predictive factors of EPS, and R software was used to establish the nomogram model. Results Of these 402 patients, 42 patients suffered from EPS, and the incidence of EPS was 10.45%. Multivariate logistic regression analysis showed that preoperative epilepsy history, non-total resection of tumor, tumor locating the frontal lobe, postoperative edema and postoperative bleeding were independent risk factors of EPS. The Harrell’s C-index of the nomogram model was 0.821 (95% CI 0.754~0.888). The predictive sensitivity and specificity were 0.857 and 0.625, respectively, and the area under ROC curve was 0.831 (95% CI 0.765~0.886). Conclusions Many factors are related to the EPS in the patients with intracranial tumor after surgery. The nomogram model has high accuracy and discriminatory power for prediction of EPS, which was established according to the preoperative history of epilepsy, the extent of tumor resection and the location of the tumor, the postoperative edema and the postoperative bleeding has good calibration and differentiation.

参考文献/References:

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备注/Memo

备注/Memo:
（2022-04-26收稿，2022-10-22修回）
基金项目：安徽省高校自然科学研究重点项目（KJ2019A0248）
通讯作者：赵　梅，E-mail：zhaomei@ahmu.edu.cn
更新日期/Last Update: 2022-12-31