Predicting mortality from intracranial hemorrhage in patients who undergo allogeneic hematopoietic stem cell transplantation.
Predicting mortality from intracranial hemorrhage in patients who undergo allogeneic hematopoietic stem cell transplantation.
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预测异体造血干细胞移植患者颅内出血死亡率。
DOI：
10.1182/bloodadvances.2021004349
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发表时间：
2021-12-14
期刊：
影响因子：
7.5
通讯作者：
Zhang, Xiaohui
中科院分区：
文献类型：
--
作者：
Ren, Xiying;Huang, Qiusha;Qu, Qingyuan;Cai, Xuan;Fu, Haixia;Mo, Xiaodong;Wang, Yu;Zheng, Yawei;Jiang, Erlie;Ye, Yishan;Luo, Yi;Chen, Shaozhen;Yang, Ting;Zhang, Yuanyuan;Han, Wei;Tang, Feifei;Mo, Wenjian;Wang, Shunqing;Li, Fei;Liu, Daihong;Zhang, Xiaoying;Zhang, Yicheng;Feng, Shuqing;Gao, Feng;Yuan, Hailong;Wang, Dao;Wan, Dingming;Chen, Huan;Chen, Yao;Wang, Jingzhi;Chen, Yuhong;Wang, Ying;Xu, Kailin;Lang, Tao;Wang, Xiaomin;Meng, Hongbin;Li, Limin;Wang, Zhiguo;Fan, Yanling;Chang, Yingjun;Xu, Lanping;Huang, Xiaojun;Zhang, Xiaohui
开发了第一个能够预测allo-HSCT患者ICH 30天死亡率的模型。LAWS评分显示出良好的辨别力和校准能力，并通过地理验证进行了外部验证。颅内出血（ICH）是异基因造血干细胞移植（allo-HSCT）的一种罕见但致命的中枢神经系统并发症。然而，在接受allo-HSCT后发生ICH的患者中，预测早期死亡率的因素尚未得到系统研究。从2008年1月至2020年6月，共有70例诊断为ICH的allo-HSCT患者组成了衍生队列。在同一时期，从其他12家医疗中心收集了41例诊断为ICH的allo-HSCT患者，他们组成了外部验证队列。这2个队列用于开发和验证分级量表，该量表能够预测全HSCT患者ICH的30天死亡率。四个预测因子（乳酸脱氢酶水平、白蛋白水平、白色血细胞计数和疾病状态）保留在多变量logistic回归模型中，并开发了简化的分级量表（称为LAWS评分）。两个队列的LAWS评分均得到充分校准（Hosmer-Lemeshow检验，P>.05）。它在推导队列（C-统计量，0.859; 95%置信区间，0.776 - 0.945）和外部验证队列（C-统计量，0.795; 95%置信区间，0.645 - 0.945）中具有良好的区分力。LAWS评分是第一个能够预测allo-HSCT患者ICH 30天死亡率的评分系统。它在识别ICH诊断后早期死亡风险增加的allo-HSCT患者方面表现出良好的性能。我们预计这将有助于对患有ICH的allo-HSCT患者进行风险分层，并促进未来针对不同LAWS风险组患者开发个性化和新型干预措施的研究。
The first model capable of predicting 30-day mortality from ICH in allo-HSCT patients was developed. The LAWS score showed good discrimination and calibration power, and was externally validated by geographical validation. Intracranial hemorrhage (ICH) is a rare but fatal central nervous system complication of allogeneic hematopoietic stem cell transplantation (allo-HSCT). However, factors that are predictive of early mortality in patients who develop ICH after undergoing allo-HSCT have not been systemically investigated. From January 2008 to June 2020, a total of 70 allo-HSCT patients with an ICH diagnosis formed the derivation cohort. Forty-one allo-HSCT patients with an ICH diagnosis were collected from 12 other medical centers during the same period, and they comprised the external validation cohort. These 2 cohorts were used to develop and validate a grading scale that enables the prediction of 30-day mortality from ICH in all-HSCT patients. Four predictors (lactate dehydrogenase level, albumin level, white blood cell count, and disease status) were retained in the multivariable logistic regression model, and a simplified grading scale (termed the LAWS score) was developed. The LAWS score was adequately calibrated (Hosmer-Lemeshow test, P > .05) in both cohorts. It had good discrimination power in both the derivation cohort (C-statistic, 0.859; 95% confidence interval, 0.776-0.945) and the external validation cohort (C-statistic, 0.795; 95% confidence interval, 0.645-0.945). The LAWS score is the first scoring system capable of predicting 30-day mortality from ICH in allo-HSCT patients. It showed good performance in identifying allo-HSCT patients at increased risk of early mortality after ICH diagnosis. We anticipate that it would help risk stratify allo-HSCT patients with ICH and facilitate future studies on developing individualized and novel interventions for patients within different LAWS risk groups.
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影响因子：
9.3
作者：
Chen CY;Tai CH;Cheng A;Wu HC;Tsay W;Liu JH;Chen PY;Huang SY;Yao M;Tang JL;Tien HF
通讯作者：
Tien HF
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作者：
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通讯作者：
Awad, Issam A.
影响因子：
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作者：
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通讯作者：
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