CN113707319A - Construction method of carbon monoxide poisoning delayed encephalopathy prediction model - Google Patents
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Abstract
The invention discloses a method for constructing a model for predicting delayed encephalopathy caused by carbon monoxide poisoning, which comprises the following steps: s1, acquiring relevant data of clinical, laboratory and image of the carbon monoxide patient; s2, carrying out single-factor analysis on the included related data, and screening to obtain an index related to the delayed encephalopathy of carbon monoxide poisoning; s3, carrying out multi-factor Logistic regression analysis on the indexes to obtain risk factor markers of the carbon monoxide poisoning delayed encephalopathy, evaluating the risk factor markers, calculating to obtain a ratio of the carbon monoxide poisoning delayed encephalopathy, establishing a nomogram, and constructing a carbon monoxide poisoning delayed encephalopathy prediction model; and S4, evaluating the calibration degree of the carbon monoxide poisoning delayed encephalopathy prediction model. The method and the device predict the risk of the delayed encephalopathy after carbon monoxide poisoning, help to intervene as early as possible, promote the recovery of patients, and reduce the mental and economic burden of the patients.
Description
Technical Field
The invention relates to the field of carbon monoxide poisoning prediction, in particular to a construction method of a carbon monoxide poisoning delayed encephalopathy prediction model.
Background
Carbon monoxide is a colorless, odorless, tasteless gas that is used as a fuel and as an exhaust gas that is not completely combusted, and is very common in industrial production and daily life. The flue gases, exhaust gases from internal combustion engines, and exhaust gases from heating and cooking appliances contain carbon monoxide. Carbon monoxide poisoning is the most common gas poisoning worldwide and is also one of the most common chemical poisoning. The delayed encephalopathy after acute carbon monoxide poisoning refers to that in acute carbon monoxide poisoning, a patient is separated from a carbon monoxide environment, and after treatment and recovery of consciousness disturbance, when symptoms of recovery appear, potential damage to brain tissues caused by acute poisoning occurs, and symptoms of different grades of consciousness disturbance, extrapyramidal nervous disturbance, Parkinson-like symptoms, pyramidal nervous damage expression, cerebral cortex focal dysfunction, epilepsy and the like occur after a period of pseudo recovery period (which can be 2-60 days, etc.).
Delayed neuroencephalopathy after carbon monoxide poisoning has indefinite incubation period, no obvious physical sign before the onset of the disease, rapid onset of the disease, loss of labor capacity of patients and even incapability of self-care in life. Once the delayed encephalopathy of carbon monoxide poisoning appears, the clinical treatment of the delayed encephalopathy is relatively difficult, the cost is high, the period is long, the heavy psychological burden is brought to patients, and simultaneously, the heavy economic burden is also brought to families and society of the patients. Therefore, it is necessary to establish a comprehensive and objective evaluation system for predicting delayed encephalopathy of carbon monoxide poisoning.
Disclosure of Invention
The invention aims to provide a method for constructing a model for predicting delayed encephalopathy caused by carbon monoxide poisoning, which aims to solve the problems in the prior art, so that the occurrence of the delayed encephalopathy caused by carbon monoxide poisoning can be predicted in advance, early intervention is facilitated, the recovery of a patient is promoted, and the economic burden of the patient is reduced.
In order to achieve the purpose, the invention provides the following scheme: the invention provides a method for constructing a model for predicting delayed encephalopathy caused by carbon monoxide poisoning, which comprises the following steps of:
s1, acquiring relevant data of clinical, laboratory and image of the carbon monoxide patient;
s2, performing single-factor analysis on the related data, and screening to obtain indexes related to the delayed encephalopathy caused by carbon monoxide poisoning;
s3, preprocessing the indexes to obtain risk factor markers of the carbon monoxide poisoning delayed encephalopathy, evaluating the risk factor markers, calculating to obtain a ratio of the carbon monoxide poisoning delayed encephalopathy, simultaneously obtaining a prediction factor, and constructing a carbon monoxide poisoning delayed encephalopathy prediction model;
and S4, evaluating the calibration degree of the carbon monoxide poisoning delayed encephalopathy prediction model.
Optionally, the related data in S1 includes five related data, namely, first related data, second related data, third related data, fourth related data and fifth related data; the first relevant data is demographic characteristic data and vital sign data of a carbon monoxide patient, the second relevant data is relevant clinical information of carbon monoxide poisoning, the third relevant data is concomitant disease data of carbon monoxide poisoning, the fourth relevant data is a blood routine index, and the fifth relevant data is imaging data.
Optionally, the first correlation data comprises: gender, age, body temperature, heart rate, blood pressure, number of breaths per minute; the second correlation data includes: carbon monoxide exposure time, end of exposure to admission time, exposure to diffusion weighted imaging scan time, glasgow coma score; the third correlation data includes: whether peripheral vascular disease exists, whether chronic basic disease complications exist, and whether malignant tumor exists; the fourth related data includes: hemoglobin count, white blood cell count, red blood cell count; the fifth correlation data includes: exposing the high-signal focus number, form and region under diffusion weighted imaging.
Optionally, the screening in S2 includes: the comparison between groups of non-normal distribution in the measurement data adopts a Whitney U test, the comparison between groups conforming to normal distribution in the measurement data adopts an independent sample t test, a chi-square test is used for the comparison between groups of counting data, and the comparison between groups of grade data adopts a rank sum test.
Optionally, the condition satisfied by the index in S2 is: p is less than 0.05.
Optionally, the preprocessing in S3 includes: and (3) bringing the index into a multifactor logistic regression model, simultaneously analyzing and evaluating, calculating to obtain a ratio of carbon monoxide poisoning delayed encephalopathy, and obtaining a prediction factor.
Optionally, the predictor comprises: DWI high signal nodules, glasgow coma score and carbon monoxide exposure time.
Optionally, the specific process of evaluating the calibration degree in S4 is as follows: evaluation was performed by a Hosimer-Leimei fitting optimization test and calibration curve.
The invention discloses the following technical effects: according to the invention, clinical symptoms and signs of the acute carbon monoxide poisoning patient, blood routine test report results and magnetic resonance image data are extracted, a simple and objective evaluation model is established to evaluate the probability of the occurrence of the delayed encephalopathy of the carbon monoxide poisoning, and a simple and visual scoring system, namely a nomogram, is established to early judge the outcome and prognosis of the delayed encephalopathy of the carbon monoxide poisoning so as to perform early related intervention, so that a basis can be provided for the acute carbon monoxide poisoning patient to adopt an individual intervention strategy, and the fitting optimization degree is good.
Drawings
In order to more clearly illustrate the embodiments of the present invention or the technical solutions in the prior art, the drawings needed to be used in the embodiments will be briefly described below, and it is obvious that the drawings in the following description are only some embodiments of the present invention, and it is obvious for those skilled in the art to obtain other drawings without inventive exercise.
FIG. 1 is a flowchart of the overall scheme of the present embodiment;
FIG. 2 is a schematic view of a prediction model alignment chart of the present embodiment;
fig. 3 is a schematic diagram of a calibration curve of the prediction model according to the present embodiment.
Detailed Description
The technical solutions in the embodiments of the present invention will be clearly and completely described below with reference to the drawings in the embodiments of the present invention, and it is obvious that the described embodiments are only a part of the embodiments of the present invention, and not all of the embodiments. All other embodiments, which can be derived by a person skilled in the art from the embodiments given herein without making any creative effort, shall fall within the protection scope of the present invention.
In order to make the aforementioned objects, features and advantages of the present invention comprehensible, embodiments accompanied with figures are described in further detail below.
As shown in fig. 1, the invention provides a method for constructing a model for predicting delayed encephalopathy caused by carbon monoxide poisoning, which comprises the following steps:
s1, acquiring relevant data of clinical, laboratory and image of the carbon monoxide patient;
s2, performing single-factor analysis on the related data, and screening to obtain indexes related to the delayed encephalopathy caused by carbon monoxide poisoning;
s3, preprocessing the indexes to obtain risk factor markers of the carbon monoxide poisoning delayed encephalopathy, evaluating the risk factor markers, calculating to obtain a ratio of the carbon monoxide poisoning delayed encephalopathy, simultaneously obtaining a prediction factor, and constructing a carbon monoxide poisoning delayed encephalopathy prediction model;
and S4, evaluating the calibration degree of the carbon monoxide poisoning delayed encephalopathy prediction model.
Optionally, the related data in S1 includes five related data, namely, first related data, second related data, third related data, fourth related data and fifth related data; the first relevant data is demographic characteristic data and vital sign data of a carbon monoxide patient, the second relevant data is relevant clinical information of carbon monoxide poisoning, the third relevant data is concomitant disease data of carbon monoxide poisoning, the fourth relevant data is a blood routine index, and the fifth relevant data is imaging data.
Optionally, the first correlation data comprises: gender, age, body temperature, heart rate, blood pressure, number of breaths per minute; the second correlation data includes: carbon monoxide exposure time, end of exposure to admission time, exposure to diffusion weighted imaging scan time, glasgow coma score; the third correlation data includes: whether peripheral vascular disease exists, whether chronic basic disease complications exist, and whether malignant tumor exists; the fourth related data includes: hemoglobin count, white blood cell count, red blood cell count; the fifth correlation data includes: exposing the high-signal focus number, form and region under diffusion weighted imaging.
Optionally, the screening in S2 includes: the comparison between groups of non-normal distribution in the measurement data adopts a Whitney U test, the comparison between groups conforming to normal distribution in the measurement data adopts an independent sample t test, a chi-square test is used for the comparison between groups of counting data, and the comparison between groups of grade data adopts a rank sum test.
Optionally, the condition satisfied by the index in S2 is: p is less than 0.05.
Optionally, the preprocessing in S3 includes: and (3) bringing the index into a multifactor logistic regression model, simultaneously analyzing and evaluating, calculating to obtain a ratio of carbon monoxide poisoning delayed encephalopathy, and obtaining a prediction factor.
Optionally, the predictor comprises: DWI high signal nodules, glasgow coma score and carbon monoxide exposure time.
Optionally, the specific process of evaluating the calibration degree in S4 is as follows: evaluation was performed by a Hosimer-Leimei fitting optimization test and calibration curve.
Glasgow Coma Score (GCS) standard score was: eye-open response score scoring criteria: opening eyes naturally: when the evaluator approaches the patient, the patient does not need to speak or touch, and the patient naturally opens the eyes for 4 points; the open eyes of the call: the patient is called at normal or high volume, without contact, and the patient can open his eyes for 3 points; pain stimulates eyes to open: the patient is stimulated with pain, and the stimulation is increased to the maximum within 10 seconds, 2 points can be obtained by strongly stimulating the eyes to open, and if only the eyebrows are frown, the eyes are closed, the face and face are painful, the score cannot be obtained. Language response score scoring criteria: the language is organized: the directional ability is correct, and the name, the city or the time of the user, etc. can be expressed initially (the above questions are only answered one), and the score is 5. Language disorder: disorientation, wrong answer, 4 points. Inappropriate vocabulary: no dialog can be made and only a short language or a single word, 3 points, can be spoken. Only pronounces: it can only make a meaningless cry for pain stimulation, 2 points. The speech cannot be given: no language reaction, 1 point. Limb movement score scoring criteria: two different actions are performed according to the instruction, and 6 minutes are spent. The pain site was located when the stimulus was applied and the patient attempted to move the limb to remove the pain stimulus for 5 points when the pain stimulus was applied. The response to painful stimuli was limb retraction, scoring 4. The response to the painful stimulus was a "decorticated and rigid" posture in 3 minutes. The response to the painful stimulus was straightening the limbs and assuming a "abolishing brain rigidity" posture for 2 minutes. No limb movement, 1 point. Degree of disturbance of consciousness corresponding to GCS score: and 4, clear consciousness under 15 points. 13-14 points, mild disturbance of consciousness (lethargy). 9-12 points, moderate disturbance of consciousness (light coma). Score 3-8, severe disturbance of consciousness (coma).
And determining a risk factor marker of delayed encephalopathy after acute carbon monoxide poisoning by adopting multi-factor Logistic regression analysis. The relation between the factors after single factor analysis and screening and the delayed encephalopathy after carbon monoxide poisoning is evaluated by using multi-factor Logistic regression analysis, the ratio of the factors to the delayed encephalopathy after carbon monoxide poisoning is calculated and predicted, the result shows that DWI high-signal nodules, Glasgow coma score and carbon monoxide exposure time are obviously related to the delayed encephalopathy after carbon monoxide poisoning, and the nomogram prediction model of the delayed encephalopathy after carbon monoxide poisoning is established by taking the three indexes as prediction factors.
And evaluating the calibration degree of the constructed histogram model, wherein the calibration degree of the prediction model can be evaluated by using a Hosimer-Leimei goodness-of-fit test and a calibration curve.
As shown in fig. 2, row 1 of the nomogram shows the reference score, and rows 2 to 4 represent the last included variable. The sum of the scores of the corresponding first row of the three variables corresponds to the total score of row 5, which corresponds to the probability of occurrence of late encephalopathy after carbon monoxide poisoning in row 6, and the nomogram shows the percentage risk of late encephalopathy after carbon monoxide poisoning. The area under the receiver-specific curve (ROC) of the constructed prediction model was 0.984.
When the P value of the goodness-of-fit test is greater than 0.2, the calibration degree is considered acceptable, and in the prediction model, P in the goodness-of-fit test is 0.468, so that the prediction model is known to have better calibration capability. And (3) constructing a calibration broken line graph according to the actual occurrence probability and the predicted occurrence probability of each research object, wherein the calibration broken line is well fitted with the reference line as shown in FIG. 3, and the prediction model is prompted to have good calibration capability.
According to the invention, clinical symptoms and signs of the acute carbon monoxide poisoning patient, blood routine test report results and magnetic resonance image data are extracted, a simple and objective evaluation model is established to evaluate the probability of the occurrence of the delayed encephalopathy of the carbon monoxide poisoning, and a simple and visual scoring system, namely a nomogram, is established to early judge the outcome and prognosis of the delayed encephalopathy of the carbon monoxide poisoning so as to perform early related intervention, and also provide a basis for the acute carbon monoxide poisoning patient to adopt an individual intervention strategy, so that the rehabilitation of the acute carbon monoxide poisoning patient is promoted.
In the description of the present invention, it is to be understood that the terms "longitudinal", "lateral", "upper", "lower", "front", "rear", "left", "right", "vertical", "horizontal", "top", "bottom", "inner", "outer", and the like, indicate orientations or positional relationships based on those shown in the drawings, are merely for convenience of description of the present invention, and do not indicate or imply that the referenced devices or elements must have a particular orientation, be constructed and operated in a particular orientation, and thus, are not to be construed as limiting the present invention.
The above-described embodiments are merely illustrative of the preferred embodiments of the present invention, and do not limit the scope of the present invention, and various modifications and improvements of the technical solutions of the present invention can be made by those skilled in the art without departing from the spirit of the present invention, and the technical solutions of the present invention are within the scope of the present invention defined by the claims.
Claims (8)
1. A method for constructing a model for predicting delayed encephalopathy caused by carbon monoxide poisoning is characterized by comprising the following steps: the method comprises the following steps:
s1, acquiring relevant data of clinical, laboratory and image of the carbon monoxide patient;
s2, performing single-factor analysis on the related data, and screening to obtain indexes related to the delayed encephalopathy caused by carbon monoxide poisoning;
s3, preprocessing the indexes to obtain risk factor markers of the carbon monoxide poisoning delayed encephalopathy, evaluating the risk factor markers, calculating to obtain a ratio of the carbon monoxide poisoning delayed encephalopathy, simultaneously obtaining a prediction factor, and constructing a carbon monoxide poisoning delayed encephalopathy prediction model;
and S4, evaluating the calibration degree of the carbon monoxide poisoning delayed encephalopathy prediction model.
2. The method for constructing a model for predicting delayed encephalopathy in carbon monoxide poisoning according to claim 1, wherein: the related data in S1 includes five related data, which are respectively first related data, second related data, third related data, fourth related data and fifth related data; the first relevant data is demographic characteristic data and vital sign data of a carbon monoxide patient, the second relevant data is relevant clinical information of carbon monoxide poisoning, the third relevant data is concomitant disease data of carbon monoxide poisoning, the fourth relevant data is a blood routine index, and the fifth relevant data is imaging data.
3. The method for constructing a model for predicting delayed encephalopathy in carbon monoxide poisoning according to claim 2, wherein: the first correlation data includes: gender, age, body temperature, heart rate, blood pressure, number of breaths per minute; the second correlation data includes: carbon monoxide exposure time, end of exposure to admission time, exposure to diffusion weighted imaging scan time, glasgow coma score; the third correlation data includes: whether peripheral vascular disease exists, whether chronic basic disease complications exist, and whether malignant tumor exists; the fourth related data includes: hemoglobin count, white blood cell count, red blood cell count; the fifth correlation data includes: exposing the high-signal focus number, form and region under diffusion weighted imaging.
4. The method for constructing a model for predicting delayed encephalopathy in carbon monoxide poisoning according to claim 3, wherein: the screening in S2 includes: the comparison between groups of non-normal distribution in the measurement data adopts a Whitney U test, the comparison between groups conforming to normal distribution in the measurement data adopts an independent sample t test, a chi-square test is used for the comparison between groups of counting data, and the comparison between groups of grade data adopts a rank sum test.
5. The method for constructing a model for predicting delayed encephalopathy in carbon monoxide poisoning according to claim 4, wherein: the condition that the index in the S2 satisfies is as follows: p is less than 0.05.
6. The method for constructing a model for predicting delayed encephalopathy in carbon monoxide poisoning according to claim 5, wherein: the preprocessing process in S3 includes: and (3) bringing the index into a multifactor logistic regression model, simultaneously analyzing and evaluating, calculating to obtain a ratio of carbon monoxide poisoning delayed encephalopathy, and obtaining a prediction factor.
7. The method for constructing a model for predicting delayed encephalopathy in carbon monoxide poisoning according to claim 6, wherein: the predictor includes: DWI high signal nodules, glasgow coma score and carbon monoxide exposure time.
8. The method for constructing a model for predicting delayed encephalopathy in carbon monoxide poisoning according to claim 7, wherein: the specific process of the calibration degree evaluation in the S4 is as follows: evaluation was performed by a Hosimer-Leimei fitting optimization test and calibration curve.
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| CN114795114A (en) * | 2022-03-29 | 2022-07-29 | 电子科技大学 | Carbon monoxide poisoning delayed encephalopathy prediction method based on multi-modal learning |
| CN114974595A (en) * | 2022-05-13 | 2022-08-30 | 江苏省人民医院（南京医科大学第一附属医院） | Crohn's disease patient mucosa healing prediction model and method |
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