个体化预测小儿营养缺铁性贫血风险列线图模型的建立

Establishment of a nomogram model for individualized prediction of the risk of nutritional iron deficiency anemia in children

目的探讨个体化预测小儿营养缺铁性贫血的危险因素,并建立列线图模型。方法选取2018年11月—2019年10月西北妇女儿童医院治疗的营养缺铁性贫血患儿300例,收集患儿的一般资料,采用多因素Logistic回归分析筛选出小儿营养缺铁性贫血的独立危险因素,对筛选出的独立危险因素建立列线图预测模型,并且验证该模型的预测性及准确性。结果小儿营养缺铁性贫血与性别、生产方式、喂养方式无关(P>0.05),与年龄、孕周、育儿教育、成长环境、偏食有关(P<0.05)。Logistic回归分析结果表明,孕周<37周、无育儿教育、农村成长和偏食均是小儿营养缺铁性贫血的独立危险因素。基于孕周、育儿教育、成长环境和偏食等4项独立危险因素,建立预测小儿营养缺铁性贫血风险的列线图模型,并且对列线图模型进行验证,结果显示预测值与实测值基本一致,说明列线图预测模型具有很好的预测能力,同时使用Bootstrap内部验证法对小儿营养缺铁性贫血的列线图模型进行验证,C-index指数为0.725(95%CI 0.696~0.754),说明列线图模型具有良好的精准性和区分性。结论小儿营养缺铁性贫血的独立危险因素主要有孕周<37周、无育儿教育、农村成长和偏食。根据小儿营养缺铁性贫血的独立危险因素建立列线图模型,可帮助临床有效的防治。

Objective To explore the individualized prediction of risk factors for nutritional iron-deficiency anemia in children,and establish a nomogram model.Methods Select 300 children with nutritional iron deficiency anemia treated by Northwest Women and Children's Hospital from November 2018 to October 2019,collect general data of the children,and use multivariate logistic regression analysis to screen out the independent risk of nutritional iron deficiency anemia in children Factors,establish a nomogram prediction model for the selected independent risk factors,and verify the predictability and accuracy of the model.Results Nutritional iron-deficiency anemia in children has nothing to do with gender,production methods,and feeding methods(P>0.05),but is related to age,gestational age,parenting education,growth environment,and partial eclipse(P<0.05).Logistic regression analysis showed that gestational age<37 weeks,no childcare education,(rural)growth and partial eclipse are all independent risk factors for iron deficiency anemia in children.Based on four independent risk factors including gestational age,parenting education,growth environment and partial eclipse,a nomogram model for predicting the risk of nutritional iron deficiency anemia in children is established,and the nomogram model is verified.The results show that the predicted value is basically the same as the measured value.Consistent,indicating that the nomogram prediction model has good predictive ability.At the same time,the Bootstrap internal verification method is used to verify the nomogram model of iron deficiency anemia in children.The C index is 0.725(95%CI 0.696~0.754).It shows that the nomogram model has good accuracy and distinguishability.Conclusion The main independent risk factors for iron deficiency anemia in children are gestational age<37 weeks,no parenting education,rural growth and partial eclipse.Establishing a nomogram model based on independent risk factors of iron deficiency anemia in children can help clinically effective prevention and treatment.