Objective To construct the risk prediction nomogram model for arrhythmia in hypertensive patients based on fragmented QRS complex(fQRS),P wave dispersion(Pd),and parameters of target organ damage in hypertension[left ventricular mass index(LVMI)and 24-hour urinary microalbumin(24 h UMA)].Methods A total of 572 patients with hypertension who were admitted to Jiaozhou Central Hospital of Qingdao from March 2023 to March 2025 were selected as the research subjects.The clinical data of the patients were collected and the occurrence of arrhythmia in the patients was statistically analyzed through follow-up.Binary Logistic regression analysis was used to explore the influencing factors of arrhythmia in hypertensive patients.The risk prediction nomogram model for arrhythmia in hypertensive patients was constructed using the"rms"package of R version 4.1.3.The consistency index(CI)was calculated using the caret package and the Bootstrap resampling method,and the Hosmer-Lemeshow goodness-of-fit test was conducted.The ROC curve was plotted using R version 4.1.3 and the area under the curve(AUC)was calculated.The decision curve was plotted using R version 4.1.3.Results During the study period,3 patients dropped out,with a dropout rate of 0.52%(3/572).A total of 569 patients were included,and they were divided into the modeling set(398 cases)and the validation set(171 cases)in a ratio of 7∶3.According to the occurrence of arrhythmia,the patients in the modeling set were divided into the arrhythmia group(125 cases)and the non-arrhythmia group(273 cases).The incidence of fQRS,LVMI,24 h UMA in the arrhythmia group were higher than those in the non-arrhythmia group,and the Pd was longer than that in the non-arrhythmia group(P<0.05).The results of the binary Logistic regression analysis showed that fQRS,Pd,LVMI,and 24 h UMA were independent influencing factors for arrhythmia in hypertensive patients(P<0.05).The risk prediction nomogram model for arrhythmia in hypertensive patients was constructed based on fQRS,Pd,LVMI and 24 h UMA.The results of the Bootstrap resampling method showed that the CI of this model in the modeling set and the validation set was 0.836 and 0.812 respectively.The Hosmer-Lemeshow goodness-of-fit test results indicated that the model had a good fit in both the modeling set and the validation set(P values were both>0.05).The ROC curve analysis results showed that the AUC of the model for predicting arrhythmia in hypertensive patients in the modeling set and validation set was 0.836[95%CI(0.795-0.878)]and 0.812[95%CI(0.746-0.878)],respectively.The results of the decision curve analysis showed that in the modeling set and the validation set,when the threshold probabilities were 0 to 0.99 and 0 to 0.97 respectively,the net benefit rate of this model was greater than 0.Conclusion The risk prediction nomogram model for arrhythmia in hypertensive patients,which was constructed based on fQRS,Pd,and parameters of target organ damage in hypertension(LVMI,24 h UMA),has good accuracy,discrimination,and clinical applicability.
(8.0+极速模式)