Development and validation of a nomogram for predicting cognitive frailty in patients on maintenance haemodialysis

IF 3.8 3区医学 Q1 NURSING

Journal of Advanced Nursing Pub Date : 2024-05-28 DOI:10.1111/jan.16253

Tong Qin, Chun Fan, Qingwei Liu, Jizhe Wang, Xiuli Zhu

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引用次数: 0

Abstract

Aims

This study aimed to construct a nomogram for predicting the risk of cognitive frailty in patients on maintenance haemodialysis.

Design

An explorative cross-sectional design was adopted.

Methods

From April 2022 to July 2022, 496 participants were recruited from five haemodialysis centres in Qingdao, Shandong Province, China. Participants with cognitive frailty were screened by Frailty Phenotype scale and Mini-Mental State Examination. Least Absolute Shrinkage and Selection Operator (LASSO) regression and multivariate logistic regression were utilized to determine predictors. The predictive performance of the nomogram was validated by calibration and discrimination. Decision curve analysis was used to assess clinical utility. Internal validation was implemented using 1000 bootstrap samples to mitigate overfitting.

Results

The prevalence of cognitive frailty was 17.5% (n = 87). Six risk predictors, namely health empowerment, alexithymia, age, educational level, marital status and dialysis vintage, were screened and used to develop a nomogram model. The nomogram had satisfactory discrimination and calibration, and decision curve analysis revealed considerable clinical utility.

Conclusions

A nomogram incorporated with the six risk predictors was developed, and it exhibited excellent prediction performance. The nomogram may strengthen the effective screening of patients at high risk of cognitive frailty.

Impact

This study established a tool for healthcare staff to predict cognitive frailty probability and identify risk factors in patients on maintenance haemodialysis. The nomogram can meet the needs of personalized care and precision medicine simultaneously.

Patient or Public Contribution

Data were collected from patients on maintenance haemodialysis by using questionnaire survey.

Reporting Method

STROBE checklist was used.

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开发并验证用于预测维持性血液透析患者认知能力衰弱程度的提名图。

目的：本研究旨在构建一个用于预测维持性血液透析患者认知虚弱风险的提名图：方法：从 2022 年 4 月至 2022 年 7 月，在 5 个国家招募了 496 名参与者：方法：2022年4月至2022年7月，从中国山东省青岛市的5家血液透析中心招募了496名参与者。认知功能虚弱者通过虚弱表型量表和迷你精神状态检查进行筛查。利用最小绝对收缩和选择操作器（LASSO）回归和多元逻辑回归确定预测因素。通过校准和辨别验证了提名图的预测性能。决策曲线分析用于评估临床实用性。使用 1000 个自举样本进行内部验证，以减少过拟合：结果：认知虚弱的患病率为 17.5%（n = 87）。筛选出了六个风险预测因素，即健康赋权、自闭症、年龄、教育程度、婚姻状况和透析年份，并将其用于建立一个提名图模型。该提名图具有令人满意的区分度和校准性，决策曲线分析表明其具有相当大的临床实用性：结论：结合六种风险预测因子开发出的提名图具有出色的预测性能。该提名图可加强对认知功能虚弱高风险患者的有效筛查：本研究为医护人员建立了一种工具，用于预测维持性血液透析患者的认知功能衰弱概率并识别风险因素。患者或公众的贡献：通过问卷调查从维持性血液透析患者中收集数据：报告方法：采用 STROBE 检查表。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of Advanced Nursing 医学-护理

CiteScore

6.40

自引率

7.90%

发文量

369

审稿时长

3 months

期刊介绍： The Journal of Advanced Nursing (JAN) contributes to the advancement of evidence-based nursing, midwifery and healthcare by disseminating high quality research and scholarship of contemporary relevance and with potential to advance knowledge for practice, education, management or policy. All JAN papers are required to have a sound scientific, evidential, theoretical or philosophical base and to be critical, questioning and scholarly in approach. As an international journal, JAN promotes diversity of research and scholarship in terms of culture, paradigm and healthcare context. For JAN’s worldwide readership, authors are expected to make clear the wider international relevance of their work and to demonstrate sensitivity to cultural considerations and differences.