Nomogram model construction for predicting pulmonary complications after deep brain stimulation and its prodictive value in patients with Parkinson's disease
10.3760/cma.j.cn115354-20200221-00096
- VernacularTitle:帕金森病患者脑深部电刺激术后肺部并发症列线图预测模型的构建及其预测价值
- Author:
Hongxia ZHUANG
1
;
Xiaolei JING
;
Xueqi WANG
;
Ruobing QIAN
;
Chaoshi NIU
Author Information
1. 中国科学技术大学附属第一医院神经外科，合肥 230032
- Keywords:
Parkinson's disease;
Postoperative pulmonary complication;
Influencing factor;
Nomogram
- From:
Chinese Journal of Neuromedicine
2021;20(3):233-239
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To explore the influencing factors for pulmonary complications of patients with Parkinson's disease (PD) after deep brain stimulation (DBS), and to construct a nomogram model for predicting pulmonary complications after DBS.Methods:Two hundred and seventy-two patients with PD accepted DBS, admitted to our hospital from March 2015 to December 2019, were chosen in our study; they were divided into pulmonary complication group ( n=56) and non-pulmonary complication group ( n=216). The clinical data of patients from the two groups were compared retrospectively. Multivariate Logistic regression was used to analyze the risk factors for pulmonary complications of patients with PD after DBS, and a nomogram model was established to predict the risk of pulmonary complications; receiver operating characteristic (ROC) curve was used to analyze the prediction performance of the model. Results:As compared with non-pulmonary complication group, the pulmonary complication group had significantly higher percentages of patients with history of pulmonary disease, preoperative albumin<35 g/L, preoperative forced expiratory volume in 1 s (FEV1)/forced vital capacity (FVC)<60%, operation time≥180 min, and age≥70 years, and significantly lower Parkinson's disease sleep scale (PDSS) scores, unified Parkinson's disease rating scale Ⅲ (UPDRS Ⅲ) scores, and preoperative albumin level, and statistically longer postoperative hospital stays ( P<0.05). Multivariate Logistic regression analysis results showed that history of pulmonary disease ( OR=4.230, 95%CI: 2.035-8.207), preoperative albumin<35 g/L ( OR=6.159, 95%CI: 2.570-5.091), preoperative FEV1/FVC<60% ( OR=31.771, 95%CI: 6.702-66.412), operation time≥180 min ( OR=3.550, 95%CI: 2.261-10.065), age≥70 years ( OR=3.714, 95%CI: 1.451-4.827), and PDSS scores ( OR=1.017, 95%CI: 1.351-13.880) were the independent risk factors for pulmonary complications of patients with PD after DBS. Nomogram model established by using the above indicators showed that area under the curve for predicting pulmonary complications of patients with PD after DBS was 0.841 ( 95%CI: 0.774-0.904, P=0.000), with sensitivity of 84.03% and specificity of 75.06%. Conclusion:PD patients with history of pulmonary disease, preoperative albumin<35 g/L, preoperative FEV1/FVC<60%, operation time≥180 min, age≥70 years, and low PDSS scores are trend to have pulmonary complications after DBS; the nomogram model based on the above variables is highly effective in predicting the risk of postoperative pulmonary complications.
