Establishing a nomogram for predicting necrotizing enterocolitis in premature infants: A retrospective multicenter cohort study.

IF 4 3区 医学 Q1 GASTROENTEROLOGY & HEPATOLOGY Digestive and Liver Disease Pub Date : 2024-09-02 DOI:10.1016/j.dld.2024.08.038
Baoquan Zhang, Wenlong Xiu, Enhuan Wei, Ronghua Zhong, Chunhui Wei, Qifan Wang, Jianmin Zheng, Zheng Yan, Xiaoying Wu, Changyi Yang
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Abstract

Background: To construct a nomogram for predicting necrotizing enterocolitis (NEC) in preterm infants.

Methods: A total of 4,724 preterm infants who were admitted into 8 hospitals between April 2019 and September 2020 were initially enrolled this retrospective multicenter cohort study. Finally, 1,092 eligible cases were divided into training set and test set based on a 7:3 ratio. A univariate logistic regression analysis was performed to compare the variables between the two groups. Stepwise backward regression, LASSO regression, and Boruta feature selection were utilized in the multivariate analysis to identify independent risk factors. Then a nomogram model was constructed based on the identified risk factors.

Results: Risk factors for NEC included gestational diabetes mellitus, gestational age, small for gestational age, patent ductus arteriosus, septicemia, red blood cell transfusion, intravenous immunoglobulin, severe feeding intolerance, and absence of breastfeeding. The nomogram model developed based on these factors showed well discriminative ability. Calibration and decision curve analysis curves confirmed the good consistency and clinical utility of the model.

Conclusions: We developed a nomogram model with strong discriminative ability, consistency, and clinical utility for predicting NEC. This model could be valuable for the early prediction of preterm infants at risk of developing NEC.

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建立预测早产儿坏死性小肠结肠炎的提名图:一项回顾性多中心队列研究。
背景:构建预测早产儿坏死性小肠结肠炎(NEC)的提名图:构建预测早产儿坏死性小肠结肠炎(NEC)的提名图:这项回顾性多中心队列研究初步纳入了2019年4月至2020年9月期间8家医院收治的4724名早产儿。最后,1092 个符合条件的病例按照 7:3 的比例被分为训练集和测试集。对两组变量进行单变量逻辑回归分析比较。在多变量分析中,利用逐步回归、LASSO 回归和 Boruta 特征选择来识别独立的风险因素。然后根据确定的风险因素构建了一个提名图模型:结果:NEC的风险因素包括妊娠糖尿病、胎龄、胎龄小、动脉导管未闭、败血症、输注红细胞、静脉注射免疫球蛋白、严重喂养不耐受和未母乳喂养。根据这些因素建立的提名图模型显示出良好的分辨能力。校准和决策曲线分析曲线证实了该模型具有良好的一致性和临床实用性:我们建立的提名图模型具有很强的判别能力、一致性和临床实用性,可用于预测 NEC。结论:我们建立的提名图模型具有很强的判别能力、一致性和临床实用性,可用于早期预测有发生 NEC 风险的早产儿。
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来源期刊
Digestive and Liver Disease
Digestive and Liver Disease 医学-胃肠肝病学
CiteScore
6.10
自引率
2.20%
发文量
632
审稿时长
19 days
期刊介绍: Digestive and Liver Disease is an international journal of Gastroenterology and Hepatology. It is the official journal of Italian Association for the Study of the Liver (AISF); Italian Association for the Study of the Pancreas (AISP); Italian Association for Digestive Endoscopy (SIED); Italian Association for Hospital Gastroenterologists and Digestive Endoscopists (AIGO); Italian Society of Gastroenterology (SIGE); Italian Society of Pediatric Gastroenterology and Hepatology (SIGENP) and Italian Group for the Study of Inflammatory Bowel Disease (IG-IBD). Digestive and Liver Disease publishes papers on basic and clinical research in the field of gastroenterology and hepatology. Contributions consist of: Original Papers Correspondence to the Editor Editorials, Reviews and Special Articles Progress Reports Image of the Month Congress Proceedings Symposia and Mini-symposia.
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