老年消化道出血患者不良预后的列线图预测模型的构建与验证
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中图分类号：R573.2 文献标志码：A DOI：10.11958/20251117
Construction and validation of nomogram prediction model for poor prognosis in elderly patients with gastrointestinal bleeding
JIN Wujuan1，NI Gang1△，HUANG Xinyu²， WANG Yangyang1 1DepartmentofGeriatrics，2Departmentoflood Transfusion，theThirdAfliated HospitalofAnhui Medical University， theFirstPeople'sHospitalofHefei，Hefei230O41，China △Corresponding Author E mail： 1205090027@qq.com
Abstract：ObjectiveTo construct and validatea nomogram prediction model for poor prognosis in elderly patients with gastrointestinalbleeding.MethodsAtotalof176elderlypatientswith gastrointestinalbleding wereenrolldas the research objects.Acording to the prognosis during hospitalization，patients were divided into the poor prognosis group （56 cases）andthegood prognosis group（12Ocases）.Theclinicaldataof thetwogroupsofpatients werecolected.Thebest variablesofpoorprognosiswerescreenedbyLassoregresionmodel，andtheselectedvariableswereincludedinthe multivariateLogisticregresion modeltoanalyze theinfluencingfactors.Nomogram wasconstructed basedontheabove influencing factors.Receiveroperating characteristic （ROC）curve，clinical calibration curveand decision curveanalysis （DCA）weredrawn tovalidate clinical practicabilityof nomogram prediction model.ResultsMultivariate Logistic regressionanalysis showed that urea nitrogen （BUN，OR=2.766，95%CI： 1.066-7.175）andhigh level of shock index （SI， OR= （20 3.853，95%Cl：1.028-14.446）were independent risk factorsof poor prognosis inelderlypatientswith gastrointestinal bleeding P<0.05 ），while highlevelsof albumin（ALB，OR=0.100，95%CI： 0.036-0.277）wereprotective factors（ P<0.05 ） ROC curve validated that the area underthe curve of the prediction model was 0.845（95%CI： 0.786-0.904）.Calibration curve showedthatthe modelhadarelativelyhighdegreeofcalibration.DCAshowed that themodelhadaclearpositivenet benefit.ConclusionThe nomogram prediction model constructed based on BUN，SI and ALB levels to predictthe poor prognosis of elderly patients with gastrointestinal bleeding has a high predictive value.
Key Words： prognosis; nomograms; aged; gastrointestinal bleeding; prediction model; model validation
消化道出血是消化系统疾病中较为常见的症状，尤其在老年男性住院患者中更为普遍[1。（剩余11224字）