Establishment and analysis of nomogram prediction model for early critical changes in children with febrile convulsion
10.3760/cma.j.cn211501-20211027-02970
- VernacularTitle:高热惊厥患儿早期病情危重变化列线图预测模型的建立及分析
- Author:
Jiafeng MIAO
1
;
Xiaoyan MI
;
Congcong YUAN
;
Qin FANG
;
Yi WANG
;
Zhaojun WANG
;
Yun WANG
Author Information
1. 安徽省儿童医院急诊科，合肥 230051
- Keywords:
Nomograms;
Febrile convulsion in children;
Severity of disease;
Early stage;
Prediction model
- From:
Chinese Journal of Practical Nursing
2022;38(30):2387-2394
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To establish a nomograph prediction model of early critical changes in children with febrile convulsion, and to provide guidance for the prevention and nursing of children with febrile convulsion.Methods:Convenient sampling method was adopted to select 384 children with febrile convulsion in Anhui Children ′s Hospital from January 2018 to April 2021 as the research objects. Based on pews, the children with febrile convulsion were divided into 334 cases of non risk group and 50 cases of risk group. Binary Logistic regression analysis were used to determine the independent risk factors affecting the early critical changes of children with febrile convulsion. A nomogram was drawn based on the independent risk factors. The discrimination and consistency of the model were verified by model ROC curve and Hosmer Lemeshow goodness of fit.The external validation of model prediction efficiency were verified by validation data. Results:Binary Logistic regression analysis showed that age, respiratory rhythm disorder, unconsciousness, breath rate, heart rate, neutrophil-to-lymphocyte ratio (NLR), red blood cell distribution width (RDW), duration of first convulsion and mean body temperature after first convulsion were influence factors for early critical changes in children with febrile convulsion ( P<0.05). The C-index of the model was 0.974 (95% CI 0.954-0.993), and the C-index of the external validation of the model was 0.922 (95% CI 0.880-0.966). The results of H-L fitting test showed that the difference was not statistically significant( χ2=0.29, P>0.05). Conclusions:The early critical changes of children with febrile convulsion may be affected by respiratory rhythm disorder, confusion of consciousness, breath rate, heart rate, NLR, RDW, duration of the first convulsion, mean temperature after the first convulsion and other factors. Pediatric emergency department should collect corresponding intervention measures for children with febrile convulsion according to the establishment of prediction model to prevent their early deterioration.
