Construction and validation of a nomogram for predicting the risk of secondary peripheral neuropathy in patients with advanced lung cancer / 浙江大学学报·医学版

OBJECTIVE@#To construct and validate a nomogram for predicting the risk of secondary peripheral neuropathy in patients with advanced lung cancer.@*METHODS@#The sociodemographic and clinical data of 335 patients with advanced lung cancer admitted to Department of Respiratory, the First Affiliated Hospital of Zhejiang University School of Medicine from May 2020 to May 2021 were retrospectively collected. Pearson correlation analysis, univariate and multivariate logistic regression analyses were used to identify the risk factors of secondary peripheral neuropathy in patients with advanced lung cancer. A nomogram was constructed according to the contribution of each risk factor to secondary peripheral neuropathy, and the receiver operating characteristic (ROC) curve, Calibration curve and clinical decision curve were used to evaluate differentiation, calibration, and the clinical utility of the model. The nomogram was further validated with data from 64 patients with advanced lung cancer admitted between June 2021 and August 2021.@*RESULTS@#The incidences of secondary peripheral neuropathy in two series of patients were 34.93% (117/335) and 40.63% (26/64), respectively. The results showed that drinking history ( OR=3.650, 95% CI: 1.523-8.746), comorbid diabetes ( OR=3.753, 95% CI: 1.396-10.086), chemotherapy ( OR=2.887, 95% CI: 1.046-7.970), targeted therapy ( OR=8.671, 95% CI: 4.107-18.306), immunotherapy ( OR=2.603, 95% CI: 1.337-5.065) and abnormal liver and kidney function ( OR=12.409, 95% CI: 4.739-32.489) were independent risk factors for secondary peripheral neuropathy (all P<0.05). A nomogram was constructed based on the above risk factors. The area under the ROC curve (AUC) of the nomogram for predicting the secondary peripheral neuropathy was 0.913 (95% CI: 0.882-0.944); and sensitivity, specificity, positive and negative predictive values were 85.47%, 81.65%, 71.43% and 91.28%, respectively. The Calibration curve and clinical decision curve showed good calibration and clinical utility. External validation results showed that the AUC was 0.764 (95% CI: 0.638-0.869); and sensitivity, specificity, positive and negative predictive values were 79.28%, 85.79%, 73.25% and 85.82%, respectively.@*CONCLUSIONS@#Advanced lung cancer patients have a high risk of secondary peripheral neuropathy after anticancer therapy. Drinking history, comorbid diabetes, chemotherapy, targeted therapy, immunotherapy, abnormal liver and kidney function are independent risk factors. The nomogram prediction model constructed in the study is effective and may be used for the risk assessment of secondary peripheral neuropathy in patients with advanced lung cancer.

Nursing care of 1 case of pulmonary space occupation combined with thoracic aortic pseudoaneurysm / 中国实用护理杂志

Objective:To summarize the nursing experience of 1 case of pulmonary space occupation with thoracic aortic pseudoaneurysm.Methods:The patients with lung occupation accompanied by chest pain were identified, evaluated and judged. Through scientific warning mechanism, rapid response team and multi-department cooperation, EVGE was performed for the patients as soon as possible, and the corresponding nursing was coordinated.Results:After the placement of the stent, the patient was immediately isolated, with free blood circulation in the distal artery, without complications such as internal fistula, paraplegia, deep vein thrombosis, etc., and was discharged from the hospital smoothly.Conclusion:Nursing thinking of "predisposing" is permeated into clinical nursing work, and it is good at finding abnormal conditions in clinical practice and improving the level of difficult and critical care.