Developing a nomogram to identify patients at risk of orthostatic hypotension in Chinese patients.

IF 1.2 4区 医学 Q4 PERIPHERAL VASCULAR DISEASE
Suli Zheng, Min Pan, Pingping Wu, Wenqin Cai
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引用次数: 0

Abstract

Objective: This study aimed to explore the factors associated with orthostatic hypotension and to develop a nomogram to predict the risk of orthostatic hypotension.

Methods: Orthostatic hypotension is defined as a fall in systolic blood pressure (SBP) of at least 20 mmHg or diastolic blood pressure (DBP) of at least 10 mmHg within 3 min of standing. In this cross-sectional analysis, 1708 patients were collected from January 2016 to June 2018. These patients were divided into the orthostatic hypotension group and the non-orthostatic hypotension group. The variables were selected by least absolute shrinkage and selection operator (LASSO) regression. The characteristic variables selected in the LASSO regression were analyzed using multivariable logistic regression to construct the predictive model. The predictive model was displayed using a nomogram. The model performances were evaluated by the area under the receiver operating characteristic curve (AUC), calibration curve, and decision curve analysis.

Results: The prevalence of orthostatic hypotension was 14.3% in this study. The LASSO and multivariable logistic regression analyses suggested that age, diabetes duration, seat SBP, supine SBP, and albumin were associated with orthostatic hypotension. The AUC of the nomogram was 0.796 [95% confidence interval (CI): 0.759-0.834] in the training set and 0.832 (95% CI: 0.780-0.885) in the validation set. Calibration curves were drawn and showed acceptable predictive performance, and the decision curve analysis showed that the proposed nomogram had strong clinical applicability.

Conclusion: Age, diabetes duration, seat SBP, supine SBP, and albumin were associated with orthostatic hypotension. The nomogram model established by the factors provided an effective way to forecast the risk of orthostatic hypotension.

建立一种体位性低血压风险识别图。
目的:本研究旨在探讨与直立性低血压相关的因素,并建立一种预测直立性低血压风险的线图。方法:直立性低血压被定义为在站立后3分钟内收缩压(SBP)至少下降20mmhg或舒张压(DBP)至少下降10mmhg。在这项横断面分析中,从2016年1月至2018年6月收集了1708名患者。将患者分为直立性低血压组和非直立性低血压组。通过最小绝对收缩和选择算子(LASSO)回归选择变量。利用多变量logistic回归对LASSO回归中选取的特征变量进行分析,构建预测模型。预测模型用图表示。通过接收机工作特性曲线(AUC)下面积、校准曲线和决策曲线分析来评价模型的性能。结果:本研究中体位性低血压的患病率为14.3%。LASSO和多变量logistic回归分析表明,年龄、糖尿病病程、坐位收缩压、仰卧收缩压和白蛋白与直立性低血压相关。训练集的nomogram AUC为0.796[95%置信区间(CI): 0.759-0.834],验证集的AUC为0.832 (95% CI: 0.780-0.885)。绘制了校正曲线并显示出可接受的预测性能,决策曲线分析表明所提出的nomogram具有较强的临床适用性。结论:年龄、糖尿病病程、坐位收缩压、仰卧收缩压和白蛋白与直立性低血压相关。由各因素建立的模态图模型为预测直立性低血压风险提供了一种有效的方法。
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
Blood Pressure Monitoring
Blood Pressure Monitoring 医学-外周血管病
CiteScore
2.00
自引率
7.70%
发文量
110
审稿时长
>12 weeks
期刊介绍: Blood Pressure Monitoring is devoted to original research in blood pressure measurement and blood pressure variability. It includes device technology, analytical methodology of blood pressure over time and its variability, clinical trials - including, but not limited to, pharmacology - involving blood pressure monitoring, blood pressure reactivity, patient evaluation, and outcomes and effectiveness research. This innovative journal contains papers dealing with all aspects of manual, automated, and ambulatory monitoring. Basic and clinical science papers are considered although the emphasis is on clinical medicine. Submitted articles undergo a preliminary review by the editor. Some articles may be returned to authors without further consideration. Those being considered for publication will undergo further assessment and peer-review by the editors and those invited to do so from a reviewer pool.
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