Development of a nomogram for predicting the outcome in patients with consciousness disorder at six months based on the evaluative information
10.3969/j.issn.1001-1242.2024.05.007
- VernacularTitle:基于评估学信息的意识障碍患者6个月结局预测列线图模型的建立
- Author:
Liwei CHEN
1
;
Jun ZHANG
;
Xiangqiang MENG
Author Information
1. 南昌大学第一附属医院康复医学科,江西省南昌市,330006
- Keywords:
disorders of consciousness;
prognostic prediction;
assessment;
nomogram
- From:
Chinese Journal of Rehabilitation Medicine
2024;39(5):655-662
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To establish a a robust and reliable nomogram for predicting the awake outcome of patients with consciousness disorder caused by brain injury at six months based on behavioral scale scores and neuroelectro-physiological techniques. Method:The clinical data(20 predictors)of patients with consciousness disorder who were first diagnosed and hospitalized in the Department of Rehabilitation Medicine of the First Affiliated Hospital of Nanchang Uni-versity from February l,2020 to Julyl,2021 were collected retrospectively.Outcome indicators were scored by the Glasgow Outcome Scale-Extended.After multiple imputation of missing values,the LASSO regression method was used to screen the optimized variables,then,the prediction model was constructed by Multivari-able Logistic regression analysis,and the nomogram was drawn.Finally,the performance of the model was evaluated by the receiver operating characteristic curve and calibration curves. Result:A total of 144 patients were included in this study according to inclusion and exclusion criteria,of which 79 had a good prognosis and 65 had a poor prognosis.Five predictors were screened out by LASSO lo-gistic regression analysis.Patients with high FOUR score,no pupil dilation,coma time＜4 weeks,SEP grade I-Ⅱ,muscle tension ≤1+had a higher probability of good prognosis at 6 months.The AUC of the model is 0.98(95％CI:0.97-0.99)＞0.75,and the prediction probability of calibration curve is in good agreement with the actual result,indicating that the model has good discrimination and calibration degree. Conclusion:The multi-domain prognostic model based on behavioral scale scores and neuroelectrophysiological techniques and clinical characteristics of patients with consciousness disorders has certain accuracy,which can provide partial reference for predicting the prognosis of patients consciousness disorders in early clinical stage.
