癌症患者化疗相关认知障碍危险因素分析及风险预测模型的构建

Analysis of risk factors for chemotherapy-related cognitive impairment in cancer patients and construction of a risk prediction model

目的探索癌症患者化疗相关认知障碍风险因素并构建风险预测模型。方法选择2021年12月-2022年11月于天津医科大学肿瘤医院肿瘤内科区城住院的336例肿瘤化疗患者,按是否发生化疗相关认知障碍分组。运用单因素和多因素logistic回归分析化疗相关认知障碍危险因素,并建立化疗相关认知障碍列线图。采用ROC曲线、校准图评价模型的预测效果。结果多因素logistic回归分析结果显示:年龄≥60岁、乳腺癌、肿瘤分期、化疗周期是化疗相关认知障碍的独立危险因素。基于上述4个危险因素建立列线图,下曲线面积(AUC)为0.796(95%CI:0.749~0.842),校准图中曲线重合度较好。结论年龄≥60岁、诊断、肿瘤分期、化疗周期是化疗相关认知障碍的独立危险因素。本研究构建的化疗相关认知障碍列线图具有较好的鉴别和预测能力,能为化疗相关认知障碍的预测和干预提供参考。

Objective To explore the risk factors of chemotherapy-related cognitive impairment in cancer patients and to construct a risk prediction model.Methods A total of 336 cancer patients who were hospitalized in the Department of Medical Oncology of Tianjin Medical University Cancer Hospital from December 2021 to November 2022 were enrolled and grouped according to whether chemotherapy-related cognitive impairment occurred,univariate and multivariate logistic regression analysis of chemotherapy-related cognitive impairment risk factors,and a nomogram of chemotherapy-related cognitive impairment was established.ROC curves and calibration charts were used to evaluate the prediction effect of the model.Results Multivariate logistic regression analysis showed that age≥60 years,breast cancer,tumor stage,and chemotherapy cycle were independent risk factors for chemotherapy-related cognitive impairment.Based on the above 4 risk factors,the nomogram was established,and the area of the lower curve(AUC)was 0.796(95%CI was 0.749-0.842),the coincidence of the curves in the calibration chart was good.Conclusions Age≥60 years,diagnosis,tumor stage,and chemotherapy cycle are independent risk factors for chemotherapy-related cognitive impairment.The nomogram of chemotherapy-related cognitive impairment constructed in this study has good identification and prediction ability,which can provide a reference for the prediction and intervention of chemotherapy-related cognitive impairment.