UNASSIGNED:多系统萎缩(MSA)患者轮椅依赖的预测因素尚不清楚。我们旨在探讨MSA患者早期轮椅依赖的预测因素,重点关注临床特征和血液生物标志物。
未经评估:这是一项前瞻性队列研究。这项研究包括2014年1月至2019年12月期间诊断为MSA的患者。在2021年10月的截止日期,符合可能MSA诊断的患者被纳入分析。随机森林(RF)用于建立早期轮椅依赖的预测模型。准确性,灵敏度,特异性,和受试者工作特征曲线下面积(AUC)用于评估模型的性能。
未经评估:总而言之,在RF模型中纳入了100例MSA患者,包括49例轮椅依赖患者和51例无轮椅依赖患者。轮椅依赖患者的基线血浆神经丝轻链(NFL)水平高于无轮椅依赖患者(P=0.037)。根据基尼指数,五个主要的预测因素是疾病持续时间,发病年龄,统一MSA评定量表(UMSARS)-II评分,NFL,和UMSARS-I得分,其次是C反应蛋白(CRP)水平,中性粒细胞与淋巴细胞比率(NLR),UMSARS-IV评分,症状发作,直立性低血压,性别,尿失禁,和诊断亚型。敏感性,特异性,准确度,RF模型的AUC为70.82%,74.55%,72.29%,和0.72。
未经证实:除了临床特征,基线特征,包括NFL,CRP,NLR是MSA早期轮椅依赖的潜在预测生物标志物。这些发现为MSA早期干预试验提供了新的见解。
UNASSIGNED: The predictive factors for wheelchair dependence in patients with multiple system atrophy (MSA) are unclear. We aimed to explore the predictive factors for early-wheelchair dependence in patients with MSA focusing on clinical features and blood biomarkers.
UNASSIGNED: This is a prospective cohort study. This study included patients diagnosed with MSA between January 2014 and December 2019. At the deadline of October 2021, patients met the diagnosis of probable MSA were included in the analysis. Random forest (RF) was used to establish a predictive model for early-wheelchair dependence. Accuracy, sensitivity, specificity, and area under the receiver operating characteristic curve (AUC) were used to evaluate the performance of the model.
UNASSIGNED: Altogether, 100 patients with MSA including 49 with wheelchair dependence and 51 without wheelchair dependence were enrolled in the RF model. Baseline plasma neurofilament light chain (NFL) levels were higher in patients with wheelchair dependence than in those without (P = 0.037). According to the Gini index, the five major predictive factors were disease duration, age of onset, Unified MSA Rating Scale (UMSARS)-II score, NFL, and UMSARS-I score, followed by C-reactive protein (CRP) levels, neutrophil-to-lymphocyte ratio (NLR), UMSARS-IV score, symptom onset, orthostatic hypotension, sex, urinary incontinence, and diagnosis subtype. The sensitivity, specificity, accuracy, and AUC of the RF model were 70.82 %, 74.55 %, 72.29 %, and 0.72, respectively.
UNASSIGNED: Besides clinical features, baseline features including NFL, CRP, and NLR were potential predictive biomarkers of early-wheelchair dependence in MSA. These findings provide new insights into the trials regarding early intervention in MSA.