基于LASSO-Firth logistic回归构建列线图模型预测住院成人心血管疾病患者的便秘风险OA
A nomogram model based on LASSO-Firth logistic regression to predict constipation risk in hospitalized adult patients with cardiovascular disease
目的 构建列线图模型预测成人心血管疾病(cardiovascular disease,CVD)患者便秘的发生风险.方法 前瞻性收集 2025年 6月 15日至 2025年 8月 15日在复旦大学附属中山医院住院的 780例成人 CVD患者的数据,将其按7∶3划分为训练集和验证集.在训练集中,基于最小绝对收缩和选择算子(the least absolute shrinkage and selection operator,LASSO)回归和 Firth logistic回归模型筛选便秘的风险因素,构建列线图模型.绘制受试者工作特征(receiver operating characteristic,ROC)曲线,并计算曲线下面积(area under the curve,AUC)以评价模型区分度;采用校准曲线及决策曲线分析(decision curve analysis,DCA)评价模型校准度和临床适用性.在验证集中验证列线图模型效能.结果 780例成人 CVD患者中,391例(50.1%)发生便秘.通过 LASSO回归和 Firth logistic回归模型共筛选出 11个变量,构建列线图模型.ROC曲线显示,模型预测训练集、验证集成人 CVD患者发生便秘的 AUC分别为 0.883、0.881;校准曲线和 DCA提示模型校准度和预测效能良好.结论 基于 LASSO-Firth logistic回归构建的列线图模型预测性能较好,可用于成人CVD患者便秘高危人群的筛查.
Objective To construct a nomogram model for prediction of constipation risk in adult patients with cardiovascular disease(CVD).Methods A total of 780 adult patients with CVD admitted to Zhongshan Hospital,Fudan University from June 15,2025 to August 15,2025 were prospectively enrolled and randomly divided into a training set and a validation set at a 7∶3 ratio.Risk factors for constipation were identified using the least absolute shrinkage and selection operator(LASSO)and Firth logistic regressions,and a nomogram model was subsequently constructed in the training set.Receiver operating characteristic(ROC)curve and the area under the curve(AUC)were used to evaluate the discrimination ability of the model.Calibration curve and decision curve analysis(DCA)were used to assess calibration and clinical applicability.The value of model was evaluated in the validation set.Results Among 780 adult patients with CVD,391 patients(50.1%)developed constipation.Eleven variables were selected by LASSO regression and Firth logistic regression,and a nomogram model was constructed.The ROC curve showed that the AUCs of the model to predict constipation in adult patients with CVD in training and validation sets were 0.881 and 0.883,respectively.Calibration curves and DCA demonstrated good calibration and predictive performance of the model in training and validation sets.Conclusions The nomogram model based on LASSO-Firth logistic regression demonstrates good predictive performance and may serve as a useful tool for identifying adult patients with CVD at high risk of constipation.
褚晓妍;林颖;卢珍珍;周芷欣;董忻悦
复旦大学附属中山医院心内科,上海 200032复旦大学附属中山医院心内科,上海 200032||复旦大学附属中山医院护理部,上海 200032复旦大学附属中山医院生物统计室,上海 200032复旦大学附属中山医院生物统计室,上海 200032复旦大学附属中山医院心内科,上海 200032
医药卫生
心血管疾病便秘成人列线图LASSO回归
cardiovascular diseaseconstipationadultnomogramLASSO regression
《中国临床医学》 2026 (4)
599-606,8
复旦大学-复星护理科研基金(FNF202415),复旦大学附属中山医院护理部循证实践项目(HLXZ202401),复旦大学附属中山医院管理科学基金(2024ZSGL15、2025ZSGL23).Supported by Fudan University-Fosun Nursing Research Fund Project(FNF202415),the Evidence-Based Practice Project of the Nursing Department at Zhongshan Hospital,Fudan University(HLXZ202401),and Management Science Fund of Zhongshan Hospital,Fudan University(2024ZSGL15,2025ZSGL23).
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