住院高血压患者伴发轻度认知功能障碍的风险预测模型构建

Construction of a risk prediction model of mild cognitive impairment in hospitalized patients with hypertension

目的 探索住院高血压患者伴发轻度认知功能障碍的危险因素,并建立风险预测列线图模型。方法 选取2021年5-11月于本院心血管内科住院的182例高血压患者,采用个人基本信息问卷、简明精神状态量表、北京版蒙特利尔认知评估量表、应对适应量表、抑郁自评量表、高血压治疗依从性量表进行调查。采用Logistic回归逐步法筛选发生轻度认知功能障碍的独立危险因素,并建立风险预测列线图模型。结果 住院高血压患者伴发轻度认知功能障碍的患病率为68.1%。基于Logistic回归分析,最终纳入年龄(OR=1.053)、糖尿病(OR=2.359)、日常生活管理行为(OR=0.926)、受教育年限(OR=0.776)、应对适应能力(OR=0.947)5个危险因素构建出风险预测模型。Calibration校正曲线提示模型准确度良好,ROC曲线下面积为0.844(95%CI 0.783~0.893),提示模型具有良好的区分度。结论 基于住院高血压患者伴发轻度认知功能障碍的危险因素构建的风险预测模型一致性和预测效能较好。

Objective To explore the risk factors of mild cognitive impairment in hospitalized patients with hypertension, and establish a risk prediction nomogram model. Methods A total of 182 patients with hypertension admitted in our hospital from May to November 2021 were enrolled in this study. They were surveyed with information questionnaire, Mini-Mental State Examination, Beijing version of Montreal Cognitive Assessment, Coping and Adaptation Processing Scale, Self-Rating Depression Scale and Therapeutic Adherence Scale. Logistic regression stepwise analysis was used to screen the independent risk factors of mild cognitive impairment, and the risk prediction nomogram model was established. Results The prevalence rate of mild cognitive impairment in hospitalized hypertensive patients was 68.1%. Based on the results of logistic regression analysis, 5 risk factors including age(OR=1.053), diabetes(OR=2.359), daily life management(OR=0.926), years of education(OR=0.776), and coping and adaptation(OR=0.947) were finally included to construct a risk prediction model. The calibration curve indicated that the model possessed good accuracy. The area under the curve was 0.844(95%CI: 0.783~0.893), indicating that the model possessed good discrimination. Conclusion Based on the risk factors of mild cognitive impairment in hospitalized hypertensive patients, our established risk prediction model has good consistency and prediction efficiency.