A Novel Differentiation Nomogram Model for Brucellar Spondylitis and Tuberculous Spondylitis.

IF 2.9 3区 医学 Q2 INFECTIOUS DISEASES
Infection and Drug Resistance Pub Date : 2024-12-27 eCollection Date: 2024-01-01 DOI:10.2147/IDR.S497404
Maimaitiyibubaji Abudukadier, Yuxin Zhang, Maozhao Li, Munire Muhetaer, Yibulayinjiang Mijiti, Zumulaiti Simayi, Maimaitijiang Aireti, Jingshun Tian, Maimaitishawutiaji Maimaiti
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引用次数: 0

Abstract

Background: Tuberculous spondylitis (TS) and brucellar spondylitis (BS) exhibit certain similarities in clinical presentation and imaging characteristics, making differential diagnosis challenging. Developing a reliable differential diagnosis model can assist clinicians in distinguishing between these two conditions at an early stage, allowing for targeted prevention and treatment strategies.

Methods: Patients diagnosed with TS and BS were retrospectively collected and randomized into training and validation cohorts (ratio 7:3). The least absolute shrinkage and selection operator (LASSO) regression was used to reduce data dimensionality and select variables. Multivariate logistic regression was used to build predictive models. A nomogram was constructed to provide a visual representation of the model. Receiver operating characteristic (ROC) curve, calibration plots and decision curve analysis (DCA) were used to measure the predictive performance of the nomogram.

Results: A total of 183 patients included (101 cases of TB, 82 cases of BS) our study. Our results showed that these variables including time from symptom onset to admission, anorexia, adenosine deaminase (ADA) and psoas abscess were important to differentiate TS and BS. The area under the curve (AUC) of ROC curve was 0.820 [95% CI (0.749, 0.892)] and 0.899 [95% CI (0.823, 0.976)] for the training and validation cohort, respectively. The results of calibration curve and DCA confirmed that the nomogram performed well in differentiating TS patient from BS.

Conclusion: The combination of time from symptom onset to admission, anorexia, ADA and psoas abscess demonstrated good differential properties for TS and BS. We developed a new nomogram model that can effectively differentiate TS and BS based on these four characteristics, which could be a valid and useful clinical tool for clinicians to aid in early differential diagnosis and targeted treatment.

一种布鲁氏菌性脊柱炎与结核性脊柱炎鉴别图模型。
背景:结核性脊柱炎(TS)和布鲁氏杆菌性脊柱炎(BS)在临床表现和影像学特征上具有一定的相似性,使得鉴别诊断具有挑战性。开发可靠的鉴别诊断模型可以帮助临床医生在早期阶段区分这两种疾病,从而制定有针对性的预防和治疗策略。方法:回顾性收集诊断为TS和BS的患者,随机分为训练组和验证组(比例为7:3)。使用最小绝对收缩和选择算子(LASSO)回归来降低数据维度和选择变量。采用多元逻辑回归建立预测模型。构造了一个nomogram来提供模型的可视化表示。采用受试者工作特征(ROC)曲线、校正图和决策曲线分析(DCA)来衡量nomogram的预测性能。结果:共纳入183例患者(TB 101例,BS 82例)。我们的研究结果显示,从症状出现到入院时间、厌食症、腺苷脱氨酶(ADA)和腰肌脓肿是区分TS和BS的重要变量。训练组和验证组ROC曲线的曲线下面积(AUC)分别为0.820 [95% CI(0.749, 0.892)]和0.899 [95% CI(0.823, 0.976)]。校准曲线和DCA的结果证实了nomogram对TS和BS的鉴别效果较好。结论:从症状出现到入院时间、厌食症、ADA和腰肌脓肿等因素综合考虑,TS和BS具有良好的鉴别特征。基于这四个特征,我们建立了一个新的nomogram模型,可以有效地区分TS和BS,为临床医生提供早期鉴别诊断和靶向治疗的有效工具。
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
Infection and Drug Resistance
Infection and Drug Resistance Medicine-Pharmacology (medical)
CiteScore
5.60
自引率
7.70%
发文量
826
审稿时长
16 weeks
期刊介绍: About Journal Editors Peer Reviewers Articles Article Publishing Charges Aims and Scope Call For Papers ISSN: 1178-6973 Editor-in-Chief: Professor Suresh Antony An international, peer-reviewed, open access journal that focuses on the optimal treatment of infection (bacterial, fungal and viral) and the development and institution of preventative strategies to minimize the development and spread of resistance.
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