Development and validation of a nomogram for steroid-resistance prediction in immune thrombocytopenia patients.
Hematology
; 26(1): 956-963, 2021 Dec.
Article
en En
| MEDLINE
| ID: mdl-34871524
ABSTRACT
OBJECTIVES:
Corticosteroid is first-line therapy in immune thrombocytopenia. However, nearly 30% of patients appear in steroid-resistance. Our research analyses the relevant indicators of patients and develops a risk prediction model to predict the poor response to steroid-therapy in ITP patients.METHODS:
We collected data from 111 ITP patients admitted to Xiamen University Zhongshan Hospital from 2013 to 2019 as the training cohort and 65 ITP patients during 2019-2020 as the external validation cohort. Screening significant factors(P < 0.05) in univariate analysis, and further identified to be independent variables in multivariable logistic regression analysis. Incorporated the significant risk factors in and presented them with a nomogram based on independent risk predictors. The nomogram was assessed by receiver operating characteristics curves and decision curve analysis.RESULTS:
We constructed a steroid-resistance prediction model based on the potential predictors including age, serum ferritin and expression of HBsAg. As a result, based on the area under the ROC curves, the training cohort (AUC 0.718, 95% CI 0.615-0.821) and the external validation cohort (AUC0.799,95%CI0.692-0.905), which displayed good discrimination. The decision curve showed that predicting the steroid-refractory risk in ITP patients using this nomogram with a range of the threshold probability between >16% and <70%. The nomogram appears good performance in predicting steroid-refractory ITP patients.CONCLUSION:
Prediction model shows that elder patients with a high level of ferritin and positive expression of HBsAg may appear a high possibility of steroid-resistance. For these patients, TPO-RAs can be considered to help patients to get better treatment effects and develop a better health-related quality of life.Palabras clave
Texto completo:
1
Banco de datos:
MEDLINE
Asunto principal:
Esteroides
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Púrpura Trombocitopénica Idiopática
Tipo de estudio:
Prognostic_studies
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Risk_factors_studies
Límite:
Adult
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Female
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Humans
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Male
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Middle aged
Idioma:
En
Revista:
Hematology
Asunto de la revista:
HEMATOLOGIA
Año:
2021
Tipo del documento:
Article