支气管哮喘患儿1年内再入院风险预测模型的构建及效能研究

Construction and validation of a prediction model for readmission risk in children with bronchial asthma within one year

目的构建支气管哮喘患儿1年内再入院风险预测模型,并分析其预测效能。方法前瞻性选取2019年12月至2020年6月在某儿童医院住院治疗的196例支气管哮喘患儿为研究对象,根据患儿1年内再入院情况将其分为未再入院组(n=164)和再入院组(n=32)。采用支气管哮喘患儿再入院风险调查表对其进行调查,通过单因素分析和Logistic回归分析筛选再入院危险因素,构建1年内再入院风险列线图预测模型,采用ROC曲线分析其预测效能。结果支气管哮喘患儿1年内再入院率为16.33%。病情严重程度分级为重度、过敏性鼻炎病史、哮喘家族史、家庭主要成员吸烟是支气管哮喘患儿1年内再入院的危险因素,哮喘控制水平高是保护因素(P<0.01或P<0.05)。再入院风险列线图预测模型ROC曲线下面积为0.916(95%CI:0.877~0.955)。结论构建的支气管哮喘患儿1年内再入院风险列线图预测模型预测效能较高,能够帮助医护人员及早识别支气管哮喘患儿再入院风险。

Objective To construct a nomogram prediction model for readmission risk in children with bronchial asthma within one year.Methods A total of 196 children with bronchial asthma who were hospitalized in a children's hospital from December 2019 to June 2020 were prospectively selected as research objects.The children were divided into non-readmission group(n=164)and readmission group(n=32)according to their readmission status within one year.The readmission risk questionnaire for children with bronchial asthma was used to investigate the children.The risk factors of readmission were screened through single factor analysis and Logistic regression analysis.The no⁃mogram predictive model for readmission risk within one year was constructed.Receiver operating characteristic(ROC)curve was used to an⁃alyze its predictive performance.Results The readmission rate within one year of children with bronchial asthma was 16.33%.The severity of the disease was severe,history of allergic rhinitis,family history of asthma,and smoking of the main family members were risk factors for read⁃mission within one year of children with bronchial asthma,and the high level of asthma control was a protective factor(P<0.01 or P<0.05).The area under the ROC curve of the readmission risk nomogram prediction model was 0.916(95%CI:0.877~0.955).Conclusion The no⁃mogram prediction model for readmission risk in children with bronchial asthma within one year has high predictive efficiency,which can help medical staff identify the risk of readmission of children with bronchial asthma early.