DOI：10.12201/bmr.202507.00001

Construction and validation of Nomogram analysis model for nausea and vomiting after lobectomy in non-small cell lung cancer patients

• 摘要：目的 探讨非小细胞肺癌(NSCLC)患者肺叶切除术后恶心呕吐的影响因素,构建并验证其列线图(Nomogram)风险预测模型。方法 选取2022年9月~2024年2月医院收治的180例NSCLC患者作为训练集,随访其术后临床资料,根据术后48 h内有无恶心呕吐分为恶心呕吐组和无恶心呕吐组。通过多因素Logistic回归分析得出独立影响因素,构建Nomogram预测模型。另选取2024年3月~2025年2月医院收治的NSCLC患者77例,将其作为验证集对模型进行验证。结果 恶心呕吐组55例(30.56%),无恶心呕吐组125例(69.44%)。多因素Logistic回归分析结果表明,手术时间(β=0.027,OR=1.027,95％CI:1.013～1.042)、性别(β=-0.921,OR=0.398,95％CI:0.184～0.864)、晕动病史(β=1.219,OR=3.385,95％CI:1.301～8.811)、术后使用阿片类药物(β=1.476,OR=4.376,95％CI:1.862～10.287)均为NSCLC患者术后恶心呕吐的独立影响因素(均P<0.05)。基于独立因素构建的预测模型ROC曲线下面积(AUC)为0.834(95%CI:0.774~0.894),敏感度为0.873,特异度为0.664,且模型校准曲线一致性较好,校准曲线贴近于标准曲线。Hosmer-Lemeshow拟合优度检验结果显示?2=9.439,P=0.307。验证集的AUC为0.895(95%CI:0.826～0.965),敏感度为0.957,特异度为0.704。结论 NSCLC患者肺叶切除术后恶心呕吐Nomogram风险预测模型展现出较高的预测效能,可帮助医护工作者有效甄别术后恶心呕吐的高危个体,为早期干预提供决策参考。

  关键词： 非小细胞肺癌; 肺叶切除术; 恶心呕吐; 影响因素; 列线图

   

  Abstract: Objective To investigate the influencing factors of nausea and vomiting in patients with non-small cell lung cancer (NSCLC) after lobectomy, and to construct and validate a nomogram risk prediction model. Method 180 NSCLC patients admitted to the hospital from September 2022 to February 2024 were selected as the training set, and their postoperative clinical data were followed up. According to whether there was nausea and vomiting within 48 hours after surgery, they were divided into nausea and vomiting group and no nausea and vomiting group. Obtain independent influencing factors through multiple logistic regression analysis and construct a nomogram prediction model. 77 NSCLC patients admitted to the hospital from March 2024 to February 2025 were selected as the validation set to validate the model. Result There were 55 cases (30.56%) in the nausea and vomiting group and 125 cases (69.44%) in the non nausea and vomiting group. Multiple logistic regression analysis showed that gender (β=-0.921, OR=0.398, 95% CI: 0.184-0.864), surgical time (β=0.027, OR=1.027, 95% CI: 1.013-1.042), history of motion sickness (β=1.219, OR=3.385, 95% CI: 1.301-8.811), and postoperative use of opioid drugs (β=1.476, OR=4.376, 95% CI: 1.862-10.287) were independent influencing factors for postoperative nausea and vomiting in NSCLC patients (all P<0.05). The area under the ROC curve (AUC) of the prediction model constructed based on independent factors is 0.834 (95% CI: 0.774~0.894), with a sensitivity of 0.873 and a specificity of 0.664. The model calibration curve has good consistency and is close to the standard curve. The Hosmer Lemeshow goodness of fit test results showed that X2=9.439, P=0.307. The AUC of external validation was 0.895 (95% CI: 0.826-0.965), with a sensitivity of 0.957 and a specificity of 0.704. Conclusion The Nomogram risk prediction model for nausea and vomiting in NSCLC patients after lobectomy demonstrates high predictive efficacy, which can help healthcare workers effectively identify high-risk individuals for postoperative nausea and vomiting and provide decision-making references for early intervention.

  Key words: Non-small cell lung cancer; Lobectomy of lung; Nausea and vomiting; Influencing factors; Nomogram

  提交时间：2025-07-01

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  1	2025-05-09	10.12201/bmr.202507.00001V1	下载

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