Article(id=1291707095196397883, tenantId=1146029695717560320, journalId=1246415772164075586, issueId=1291707004800750583, articleNumber=null, orderNo=null, doi=10.13699/j.cnki.1001-6821.2025.22.013, pmid=null, cstr=null, oa=null, hot=null, price=null, onlineType=0, articleFormat=0, articleType=null, articleTypeStr=null, receivedDate=1760284800000, receivedDateStr=2025-10-13, revisedDate=null, revisedDateStr=null, acceptedDate=null, acceptedDateStr=null, onlineDate=1785896570251, onlineDateStr=2026-08-05, pubDate=1764259200000, pubDateStr=2025-11-28, doiRegisterDate=null, doiRegisterDateStr=null, onlineIssueDate=1785896570251, onlineIssueDateStr=2026-08-05, onlineJustAcceptDate=null, onlineJustAcceptDateStr=null, onlineFirstDate=null, onlineFirstDateStr=null, sourceXml=null, magXml=null, createTime=1785896570251, creator=13701087609, updateTime=1785896570251, updator=13701087609, issue=Issue{id=1291707004800750583, tenantId=1146029695717560320, journalId=1246415772164075586, year='2025', volume='41', issue='22', pageStart='3151', pageEnd='3300', issueExtLink='null', onlineDate='null', pubDate='1764259200000', pubDateStr='2025-11-28', beforeIssueId=null, nextIssueId=null, price=null, status=1, issueComplete=1, articleOrder=1, issueType=-1, specialIssue=null, createTime=1785896548700, creator='13701087609', updateTime=1785896693213, updator='13701087609', preIssue=null, nextIssue=null, articleTotal=null, ext={EN=IssueExt(id=1291707610999316815, tenantId=1146029695717560320, journalId=1246415772164075586, issueId=1291707004800750583, language=EN, specialIssueTitle=, coverIllustrator=null, specialIssueEditor=, specialIssueAbout=), CN=IssueExt(id=1291707610999316816, tenantId=1146029695717560320, journalId=1246415772164075586, issueId=1291707004800750583, language=CN, specialIssueTitle=, coverIllustrator=null, specialIssueEditor=, specialIssueAbout=)}, issueFiles=null, downloadFileDto=null}, startPage=3234, endPage=3240, ext={EN=ArticleExt(id=1291707096395968828, articleId=1291707095196397883, tenantId=1146029695717560320, journalId=1246415772164075586, language=EN, title=Development and validation of a prediction model for potentially inappropriate medications in elderly inpatients with ischemic stroke, columnId=1291704944038536012, journalTitle=Chinese Journal of Clinical Pharmacology, columnName=Rational Use of Drugs, runingTitle=null, highlight=null, articleAbstract=
Objective To investigate the prevalence and associated influencing factors of potentially inappropriate medications (PIM) in elderly hospitalized patients with ischemic stroke, and to construct a risk prediction model for this population. This study aimed to provide decision support for identifying high-risk patients and ensuring rational clinical medication use.
Methods Retrospective analysis was performed on the medical records of elderly hospitalized patients with ischemic stroke admitted to our hospital from January 2021 to December 2023. The 2023 version of the Beers Criteria was adopted to assess PIM. Univariate and multivariate Logistic regression analyses were applied to identify risk factors associated with PIM, and the optimal model was ascertained via the Akaike information criterion (AIC) followed by nomogram development. The discriminative ability, calibration, and clinical utility of the model were evaluated systematically.
Results A total of 1 797 patients were included, among whom 866 (48.19%) had PIM, involving 1 756 PIM episodes. Multivariate Logistic regression analysis revealed that female gender, number of medications≥10 types, National Institutes of Health Stroke Scale (NIHSS) score of >5 points, personal history of cerebral infarction, type 2 diabetes mellitus, coronary heart disease, and atrial fibrillation were independent risk factors for PIM (P<0.05, P<0.001). Validation of the nomogram model showed an area under curve (AUC) of the receiver operating characteristic of 0.73. The Hosmer-Lemeshow goodness-of-fit test showed a P-value >0.05, meaning the model fit well, and there was good agreement between the calibration curve and the ideal curve. Clinical decision curve analysis (DCA) demonstrated that when the threshold probability ranged from 15% to 87%, the model achieved a high net benefit, confirming its clinical practical value.
Conclusion The constructed nomogram model exhibits good discriminative ability, calibration, and clinical applicability. It can accurately predict the risk of PIM in elderly patients with ischemic stroke, facilitating early clinical risk identification and targeted intervention implementation.
, authors=Yu-han ZHAO, Ning ZHANG, Jun CHEN, Wei-gen XIONG, Xiao-fang TAN, authorsList=Yu-han ZHAO, Ning ZHANG, Jun CHEN, Wei-gen XIONG, Xiao-fang TAN, authorCompany=null, correspAuthors=Xiao-fang TAN, authorNote=null, correspAuthorsNote=null, copyrightStatement=null, copyrightOwner=null, extLink=null, articleAbsUrl=null, sourceXml=null, magXml=null, pdfUrl=null, pdf=null, pdfFileSize=null, pdfExtLink=null, richHtmlUrl=null, mobilePdfUrl=null, reviewReport=null, pdfFirstPage=null, abstractGraph=null, abstractGraphContent=null, abstractVideo=null, citation=null, cebUrl=null, magXmlContent=null, mapNumber=null, fund=null), CN=ArticleExt(id=1291707097603928381, articleId=1291707095196397883, tenantId=1146029695717560320, journalId=1246415772164075586, language=CN, title=老年缺血性脑卒中住院患者潜在不适当用药预测模型的构建与验证, columnId=1291704944210502478, journalTitle=中国临床药理学杂志, columnName=合理用药, runingTitle=null, highlight=null, articleAbstract=
目的 探讨老年缺血性脑卒中住院患者潜在不适当用药（PIM）情况及相关影响因素，并构建相应的PIM风险预测模型，为识别高危患者，保障临床合理用药提供决策支持。
方法 回顾性分析2021年1月至2023年12月本院收治的老年缺血性脑卒中住院患者病历，使用Beers标准（2023版）评估患者PIM情况，采用单因素和多因素Logistic回归分析方法筛选老年缺血性脑卒中患者PIM发生的危险因素，利用赤池信息准则（AIC）决定最优模型并绘制列线图。并评价了模型的区分度、校准度和临床实用性。
结果 本研究共纳入1 797例患者，共有866例（48.19%）患者发生PIM，涉及1 756例次PIM。通过多因素Logistic回归分析发现，女性、药品种数≥10种、美国国立卫生研究院卒中量表（NIHSS）评分>5分、合并脑梗死个人史、2型糖尿病、冠心病和心房颤动是PIM发生的危险因素（均P<0.05，P<0.001）。列线图预测模型验证结果显示，受试者工作特征曲线下面积为0.73；Hosmer-Lemeshow拟合优度检验结果显示P值>0.05，模型拟合效果良好，校准曲线和理想曲线重合程度较好；临床决策曲线分析（DCA）结果显示，当阈值概率介于15%～87%之间时，净获益值较高，具有临床应用价值。
结论 本研究构建的列线图模型具有较好的区分度、校准效果及临床使用价值，可准确预测老年缺血性脑卒中患者PIM的风险，有助于临床早期识别风险并实施干预措施。
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赵宇晗（1989-），女，硕士研究生，主要从事医院药物警戒方面的研究
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