Development and validation of routine clinical laboratory data derived marker-based nomograms for the prediction of 5-year graft survival in kidney transplant recipients.
Development and validation of routine clinical laboratory data derived marker-based nomograms for the prediction of 5-year graft survival in kidney transplant recipients.
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开发和验证常规临床实验室数据衍生的基于标记的列线图，用于预测肾移植受者的 5 年移植物存活率
DOI：
10.18632/aging.202748
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发表时间：
2021-03-26
期刊：
影响因子：
--
通讯作者：
Shi Y
中科院分区：
文献类型：
--
作者：
Li Y;Yan L;Li Y;Wan Z;Bai Y;Wang X;Hu S;Wu X;Yang C;Fan J;Xu H;Wang L;Shi Y
背景：开发和验证预测肾移植受者(KTRs)5年移植物存活率的诺模图，该图具有易于获得的实验室数据、衍生的标记物和移植后第一年的临床变量。方法：收集1289例肾移植患者移植后1年内的临床和常规实验室数据，以生成候选预测因子。进行单变量和多变量Cox分析及套索分析以选择最终预测因素。应用X-Tile分析确定最佳截断值，将潜在的连续因素转化为类别变量，并对患者进行分层。采用C指数、校准曲线、动态时变AUC、决策曲线分析和Kaplan-Meier曲线评价模型的预测准确性和临床实用性。结果：利用0-6个月和0-12个月的实验室数据构建了两个预测诺模图，并在训练队列中表现出较好的预测性能，C指数分别为0.78和0.85。校准曲线表明，移植物5年存活率的预测概率与实际观察结果一致。此外，通过诺模图可以将KDR成功地分层为三个风险组。结论：这些预测性诺模图结合了来自移植后实验室数据的人口学和0-6或0-12个月标记物，可以作为早期识别个体KDR移植物5年存活概率的有用工具。
Background: To develop and validate predictive nomograms for 5-year graft survival in kidney transplant recipients (KTRs) with easily-available laboratory data derived markers and clinical variables within the first year post-transplant. Methods: The clinical and routine laboratory data from within the first year post-transplant of 1289 KTRs was collected to generate candidate predictors. Univariate and multivariate Cox analyses and LASSO were conducted to select final predictors. X-tile analysis was applied to identify optimal cutoff values to transform potential continuous factors into category variables and stratify patients. C-index, calibration curve, dynamic time-dependent AUC, decision curve analysis, and Kaplan-Meier curves were used to evaluate models’ predictive accuracy and clinical utility. Results: Two predictive nomograms were constructed by using 0–6- and 0–12- month laboratory data, and showed good predictive performance with C-indexes of 0.78 and 0.85, respectively, in the training cohort. Calibration curves showed that the prediction probabilities of 5-year graft survival were in concordance with actual observations. Additionally, KTRs could be successfully stratified into three risk groups by nomograms. Conclusions: These predictive nomograms combining demographic and 0–6- or 0–12- month markers derived from post-transplant laboratory data could serve as useful tools for early identification of 5-year graft survival probability in individual KTRs.
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影响因子：
2.3
作者：
Ergin, Giray;Deger, S. Muge;Arinsoy, Turgay
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4.3
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