脑卒中病人入院后新发抑郁风险的预测模型构建及验证

目的构建脑卒中病人入院后新发抑郁风险的预测模型，并验证该预测模型的预测效果。方法选择入院前无抑郁症的脑卒中病人916例，按照入院后1周是否发生抑郁分为新发抑郁组和非抑郁组，采用单因素和多因素logistic回归模型分析新发抑郁的影响因素，建立预测模型，并绘制列线图，同时采用ROC曲线和Hosmer-Lemeshow检验评估模型预测效果。选择2020年4月至2021年4月住院病人298例作为模型验证组。结果模型构建组和验证组病人的新发抑郁率分别为31.8%和32.9%。年龄、体质量指数、教育程度、家庭人均年收入、睡眠质量、睡眠时间、入院后的照护情况、Barthel指数和NIHSS评分为脑卒中病人入院后新发抑郁的影响因素(P < 0.05)。预测模型验证结果显示区分度较好，模型构建组和验证组病人入院后新发抑郁风险的ROC曲线下面积分别为0.868和0.813(P < 0.01)；同时校准度也较高，2组Hosmer-Lemeshow检验的P值分别为0.817和0.389。结论构建预测模型可以有效预测脑卒中病人入院后新发抑郁的发生，为临床护理工作中对脑卒中病人进行及时心理干预提供了参考。

Construction and validation of a prediction model for the risk of new-onset depression in stroke patients after admission

ObjectiveTo construct and validate a prediction model for the risk of new-onset depression in stroke patients after admission.MethodsA total of 916 stroke patients who without depression before admission were selected.These patients were divided into the new-onset depression group and the non-depression group according to the occurrence of depression in the first week after admission.Single-factor and multi-factor logistic regression models were used to analyze the influencing factors of new-onset depression and establish the prediction model.Then the nomogram was draw.Meanwhile, the area under the ROC curve and Hosmer-Lemeshow test were used to evaluate the prediction effect of the model.A total of 298 hospitalized patients from April 2020 to April 2021 were selected as the model validation group.ResultsThe incidence of new-onset depression in the model building group and validation group was 31.8% and 32.9%, respectively.Age, body mass index, education level, per capita annual household income, sleep quality, sleep duration, care after admission, Barthel index and NIHSS score were the influencing factors of new-onset depression in stroke patients after admission(P < 0.05).The validation results of the prediction model showed that the discrimination was good.The area under ROC curve of the risk of new-onset depression(P < 0.05) after admission was 0.868 in the model construction group and 0.813 in the validation group, respectively(P < 0.01).The calibration degree was also high, and the P values of Hosmer-Lemeshow test were 0.817 and 0.389, respectively.ConclusionsThe prediction model constructed can effectively predict the occurrence of new-onset depression in stroke patients after admission, providing a reference for timely psychological intervention in clinical nursing work for stroke patients.