[Construction and evaluation of a model for predicting ischemic stroke risk in patients with sudden sensorineural hearing loss].

ABSTRACT

Objective:To explore the related factors of sudden sensorineural hearing loss complicated with ischemic stroke, construct the risk prediction model, and verify the prediction effect of the model. Methods:A retrospective analysis was performed on 901 sudden sensorineural hearing loss patients hospitalized from January 2017 to December 2020, The patients were divided into the ischemic stroke group（100 cases） and the sudden deafness group（801 cases） according to whether they were complicated with ischemic stroke, The independent correlation factors of sudden deafness complicated with ischemic stroke were screened by univariate analysis and multivariate Logistic regression model, and the risk prediction model and internal verification were established. The original data were randomly divided into the modeling group（631 cases） and the validation group（270 cases） at a 7∶3 ratio. Hosmer-Lemeshow and receiver operating characteristic curve were used to test the goodness of fit and predictive effect of the model, and 270 patients were included again in the application research of the model and to test the prediction effect of the model. Results:The results of single factor analysis showed that age, NEUR, NC, NLR, PLR, TC, HDL-C, BUN, TC-HDL-C, TG/HDL-C, LDL-C/HDL-C, Hcy, FIB and cervical vascular plaque were related factors of sudden sensorineural hearing loss complicated with ischemic stroke（P<0.05）. Age（OR=2.816）, NEUR（OR=2.707）, Hcy（OR=88.833）, FIB（OR=1.389）, TC-HDL-C（OR=1.613）, cervical vascular plaque（OR=2.862） are the independent risk factors of SNHL complicated with ischemic stroke. These 6 factors are used to construct a prediction model. Hosmer-lemeshow test results, the area under the ROC curve of the modeling group was 0.846, P=0.555, Youden index was 0.564, sensitivity was 0.820, and specificity was 0.744. In the validation group, the area under ROC curve was 0.847, P=0.288, Youden index was 0.432, sensitivity was 0.783, and specificity was 0.649. Conclusion:The risk prediction model constructed in this study shows good prediction efficiency. which can provide references for the clinical screening of ischemic stroke risks in patients with sudden sensorineural hearing loss and early interventions in early stage.