Diao Yangyang,Zhang Yutai,Li Chaoran,et al.Risk factor analysis of secondary hydrocephalus after neonatal germinal matrix-intraventricular hemorrhage[J].Journal of Clinical Pediatric Surgery,,():111-117.[doi:10.3760/cma.j.cn101785-20251029-00026]
Risk factor analysis of secondary hydrocephalus after neonatal germinal matrix-intraventricular hemorrhage
- Keywords:
- Infant; Newborn; Germinal Matrix-Intraventricular Hemorrhage; Hydrocephalus; Risk Factors; Nomograms
- Abstract:
- Objective To investigate the independent risk factors for secondary hydrocephalus after neonatal germinal matrix-intraventricular hemorrhage and to construct an individualized risk prediction nomogram model. Methods A single-center retrospective study was conducted including neonates with germinal matrix-intraventricular hemorrhage admitted to the Children’s Hospital of Chongqing Medical University between November 2020 and June 2025. According to the occurrence of secondary hydrocephalus,patients were divided into a hydrocephalus group (34 cases) and a non-hydrocephalus group (102 cases). Propensity score matching (1∶3) was applied to balance baseline characteristics between the two groups. Least absolute shrinkage and selection operator (LASSO) regression was applied to screen predictive variables,and Bayesian logistic regression was subsequently used to identify independent risk factors. A nomogram prediction model was constructed based on these factors,and internal validation was performed using bootstrap resampling to evaluate the model’s discrimination,calibration,and clinical utility. Results Bayesian logistic regression analysis showed that Papile grade Ⅲ/Ⅳ (OR=3733.64,95%CI:185.28-190951.05,P<0.001),concomitant intracranial infection (OR=62.81,95%CI:6.21-1137.87,P<0.001),and birth weight ≥1 500 g (OR=23.46,95%CI:2.03-448.89,P=0.007) were independent risk factors for secondary hydrocephalus after neonatal germinal matrix-intraventricular hemorrhage,whereas patent ductus arteriosus was a protective factor (OR=0.06,95%CI:0.00-0.54,P=0.008). The nomogram model constructed based on these factors demonstrated a concordance index (C-index) of 0.986 on internal validation,an area under the receiver operating characteristic (ROC) curve (AUC) of 0.984,and calibration and decision curve analyses indicating good discrimination,calibration,and clinical utility. Conclusions The nomogram model constructed in this study effectively predicts the risk of secondary hydrocephalus after neonatal germinal matrix-intraventricular hemorrhage,facilitating early identification of high-risk neonates and providing a quantitative tool for individualized intervention.
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Memo
收稿日期:2025-10-29。
通讯作者:纪文元,Email:282207152@qq.com