1型糖尿病患儿1年内再入院风险列线图预测模型的构建及验证

Construction of a nomogram predictive model for readmission risk within 1 year of children with typeldiabetes and its verification

目的构建和验证1型糖尿病患儿1年内再入院风险列线图预测模型。方法选取2019年2月至2021年2月在西安市4所医院住院治疗的395例1型糖尿病患儿为研究对象, 以5∶4的比例将其分为训练集219例和验证集176例, 以训练集资料构建1型糖尿病患儿1年内再入院风险列线图预测模型, 并进行内部验证;以验证集资料对模型进行外部验证。结果 85例占21.5%的患儿1年内再入院, 平均糖化血红蛋白≥7.5%、合并感染、合并糖尿病并发症、糖尿病家族史是1型糖尿病患儿1年内再入院的危险因素(OR值为4.010~5.510, P<0.05), 起病年龄>7岁是保护因素(OR = 0.070, P<0.05)。列线图预测模型内部验证显示, ROC曲线下面积为0.778(95%CI 0.703~0.853), 校准曲线中观察曲线和预测曲线基本吻合;外部验证显示, ROC曲线下面积为0.748(95%CI 0.642~0.854), 校准曲线中观察曲线和预测曲线基本吻合。结论 1型糖尿病患儿1年内再入院风险列线图预测模型具有科学性和实用性, 在指导1型糖尿病患儿1年内再入院的针对性预防和干预方面具有一定应用价值。

Objective To construct and validate a nomogram predictive model for readmission risk within 1 year of children with type 1 diabetes.Methods A total of 395 children with type 1 diabetes who were hospitalized in four hospitals in Xi'an City from February 2019 to February 2021 were selected as the research subjects.The children were divided into training set(n=219)and verification set(n=175)in 5:4 ratios.A nomogram prediction model for readmission risk within 1 year of children with type 1 diabetes was constructed based on the training set data,and internal validation was carried out.The external validation was carried out based on validation set data.Results A total of 85(21.5%)children were readmitted within 1 year.Mean glycohemoglobin Alc≥7.5%,co-infection,complications of diabetes,and family history of diabetes were risk factors for readmission within 1 year of children with type 1 diabetes(OR values were 4.010-5.510,P<0.05),and age of onset>7 years old was a protective factor(OR=0.070,P<0.05).The internal verification of nomogram model showed that the area under ROC curve was 0.778(95%CI 0.703-0.853),and the observed curve in calibration curve was basically consistent with the predicted curve.The external verification showed that the area under ROC curve was 0.748(95%CI 0.642-0.854),and the observed curve in calibration curve was basically consistent with the predicted curve.Conclusions The nomogram predictive model for readmission risk within 1 year of children with type 1 diabetes is scientific and practical,and has certain clinical value in guiding targeted prevention and intervention of readmission of children with type 1 diabetes within one year.