Construction of nomogram predictive model for mental state in patients after retinal detachment reduction surgery and its verification

Objective To construct a predictive model for the psychological state of patients after retinal detachment reduction, and to verify the predictive effect of the model.

Methods The clinical data of 238 patients who underwent retinal detachment reduction were collected, the included subjects were divided into modeling group (143 cases) and validation group (95 cases) at a ratio of 6∶4; Self-rating Anxiety Scale (SAS) and Self-rating Depression Scale (SDS) were used to evaluate the poor psychological state of patients; univariate and multivariate Logistic regression analysis were used to analyze the risk factors affecting the psychological state of patients after retinal detachment, and a risk prediction model was established. Receiver operating characteristic (ROC) curve and calibration curve were drawn to evaluate the predictive effectiveness of the model, and Hosmer-Lemeshow goodness-of-fit test was performed.

Results In 143 patients in the modeling group, 96 patients(67.13%) with retinal detachment had negative psychological state; the results of univariate analysis showed that age, economic pressure, complicating with chronic diseases, insomnia, time since preoperative retinal detachment, and visual acuity of the other eye were the influencing factors of the psychological state of patients after retinal detachment (P < 0.05); multivariate Logistic regression analysis showed that age < 55 years old (OR=3.214), financial stress (OR=3.328), complicating with chronic disease (OR=3.631), insomnia (OR=7.886), time since preoperative retinal detachment (>7 d) (OR=5.897) and visual impairment in the other eye (OR=6.133) were risk factors for negative psychology (P < 0.05). The results of the Hosmer-Lemeshow goodness of fit test showed that established model based on risk factors had a good degree of calibration in both modeling group(χ²=6.470, P=0.595)and validation group(χ²=6.343, P=0.535); the calibration curves of the modeling group and the validation group showed that the risk of negative emotions predicted by the model was in good agreement with the risk that actually occurred; the results of the ROC curve showed that the area under the curve for predicting the occurrence of negative emotions in the modeling group and the validation group was 0.909 (95%CI, 0.849 to 0.951) and 0.902 (95%CI, 0.824 to 0.954), respectively.

Conclusion Based on the influencing factors of psychological state in patients after retinal detachment repositioning (age, economic pressure, complicating with chronic diseases, insomnia, time from retinal detachment to surgery, visual acuity of the other eye), the nomogram prediction model has better differentiation, effectiveness, which can provide a reference for the selection of clinical treatment for such patients.