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首页> 外文期刊>Journal of stroke and cerebrovascular diseases: The official journal of National Stroke Association >Development and Validation of a Nomogram for Lower Extremity Deep Venous Thrombosis in Patients after Acute Stroke
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Development and Validation of a Nomogram for Lower Extremity Deep Venous Thrombosis in Patients after Acute Stroke

机译：急性中风后患者下肢深静脉血栓形成的探测和验证

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Objectives: To develope and validate a nomogram to predict the probability of deep venous thrombosis (DVT) in patients after acute stroke during the first 14 days with clinical features and easily obtainable biochemical parameters. Methods: This is a single-center prospective cohort study. The potential predictive variables for DVT at baseline were collected, and the presence of DVT was evaluated using ultrasonography within the first 14 days. Data were randomly assigned to either a modeling data set or a validation data set. Univariable and Multivariate logistic regression analysis was used to develop risk scores to predict DVT in the modeling data set and the area under the receiver operating characteristic curve to validate the score in the test data set, and nomogram and calibration curve were constructed by R project. Results: A total of 1651 patients with acute stroke were enrolled in the study. The overall incidence of DVT after acute stroke within two weeks was 14.4%. Multivariable analysis detected older age (>= 65 years),female gender, hemorrhagic stroke, malignancy, lower limb muscle strength 0.5 mg.L-1 were highly predictive of 14-day risk of DVT. The AUC of the nomogram with these above-mentioned independent risk factors to predict the 14-day risk of DVT was 0.756 (95% CI, 0.712-0.812) and 0.811 (95%CI, 0.762-0.859) for the modeling cohort and external validation cohort, respectively. Moreover, the calibration of the nomogram showed a nonsignificant Hosmer-Lemeshow test statistic in the modeling (P = 0.250) and validation sets (P = 0.995). With respect to decision curve analyses, the nomogram exhibited preferable net benefit gains than the staging system across a wide range of threshold probabilities. Conclusion: This nomogram had a good performance in predictive accuracy, discrimination capability, and clinical utility, which was helpful for clinicians to identify high-risk groups of DVT and formulate relevant prevention and treatment measures.
机译：目的：开发并验证一个诺模图，以预测急性脑卒中患者在最初14天内发生深静脉血栓形成（DVT）的概率，该诺模图具有临床特征和易于获得的生化参数。方法：这是一项单中心前瞻性队列研究。收集基线时DVT的潜在预测变量，并在最初14天内使用超声检查评估DVT的存在。数据被随机分配到建模数据集或验证数据集。采用单变量和多变量logistic回归分析，在建模数据集和受试者操作特征曲线下的面积中建立预测DVT的风险评分，以验证测试数据集中的评分，并通过R项目构建诺模图和校准曲线。结果：共有1651名急性脑卒中患者被纳入研究。急性卒中后两周内DVT的总发生率为14.4%。多变量分析发现年龄较大（>=65岁）、女性、出血性中风、恶性肿瘤、下肢肌力0.5 mg。L-1高度预测14天的DVT风险。对于建模队列和外部验证队列，具有上述独立风险因素的列线图预测DVT 14天风险的AUC分别为0.756（95%CI，0.712-0.812）和0.811（95%CI，0.762-0.859）。此外，列线图的校准显示，在建模（P=0.250）和验证集（P=0.995）中，Hosmer-Lemeshow检验统计量不显著。关于决策曲线分析，在很大范围的阈值概率中，列线图显示出比分期系统更好的净效益收益。结论：该诺模图在预测准确性、鉴别能力和临床实用性方面有良好的表现，有助于临床医生识别DVT高危人群，制定相应的预防和治疗措施。

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