【摘要】 目的 研究住院老年癌症患者口腔衰弱的独立预测因子，开发预测模型并绘制列线图，同时对模型的预测效能进行验证。方法 采用便利抽样法，选取2024年5月至2024年8月苏州市两家三级甲等医院收治的406例老年癌症患者作为调查对象，将其随机分为建模组295例和验证组111例，运用logistic回归分析老年癌症患者发生口腔衰弱的潜在风险因素，通过R语言工具建立风险预测模型及相应的列线图，并通过ROC曲线评估模型的拟合度和预测性能。结果 单因素分析显示，年龄、婚姻、文化程度、放疗、化疗、握力、老年人口腔健康相关自我效能量表评分、口腔黏膜炎、口腔健康不良、营养风险对老年癌症患者发生口腔衰弱有影响（P<0.05）。Logistic回归分析显示，年龄、放疗、口腔黏膜炎、握力、口腔健康不良、口腔自我效能低、营养风险高是老年癌症患者发生口腔衰弱的独立影响因素（P<0.05）。构建老年癌症患者口腔衰弱风险预测列线图，Hosmer-Lemeshow检验评价拟合优度效果，检验结果显示χ2=0.439,P=0.932。建模集曲线下面积为0.954(95%CI:0.934～0.974)，验证集平均曲线下面积为0.977(95%CI:0.957～0.998)。结论 基于高龄、放疗、握力、口腔黏膜炎、营养风险、口腔健康相关自我效能量、口腔健康不良构建的列线图模型具有良好的区分度和校准度，能够帮助医护人员筛查老年癌症患者发生口腔衰弱的高危人群，采取合适的干预措施，降低口腔衰弱的发生风险。更多还原

【Abstract】 Objective To investigate the independent predictors of oral frailty among hospitalized elderly cancer patients develop a predictive model and draw a nomogram, and simultaneously validate the predictive performance of the model. Methods Employing a method of convenience sampling, 406 senior cancer patients from hospitals in two advanced facilities in Suzhou City were selected during May 2024 to August 2024.The patients were divided into modeling group(295 cases) and validation group(111 cases).Logistic regression was utilized to investigate the factors leading to oral frailty in older cancer patients. The risk prediction model and nomograms model were constructed using R software,and the area under the receiver operating characteristic(ROC) curve was used to test the prediction effect of the model.Results Univariate analysis revealed that age, marital status, educational attainment, radiotherapy, chemotherapy,grip strength, the scores of geriatric self-efficacy scale for oral health, oral mucositis, poor oral health, and nutritional risk significantly influenced the development of oral frailty in elderly cancer patients(P <0.05). Logistic regression analysis demonstrated that age, radiotherapy, oral mucositis, reduced grip strength, poor oral health, low oral health selfefficacy, and high nutritional risk as independent predictors of oral frailty in this population(P<0.05).A nomogram was constructed to predict oral frailty risk in elderly cancer patients. The Hosmer-Lemeshow test demonstrated excellent model calibration(χ2=0.439, P=0.932). The model showed outstanding discriminative ability with an area under the curve(AUC) of 0.954(95%CI: 0.934-0.974) in the training cohort and 0.977(95%CI: 0.957-0.998) in the validation cohort.Conclusion The nomogram model constructed based on advanced age, radiotherapy, grip strength, oral mucositis,nutritional risk, oral health-related self-efficacy, and poor oral health exhibits excellent discrimination and calibration.It can assist medical staff in screening high-risk groups of elderly cancer patients for oral frailty, adopt appropriate intervention measures, and decrease the occurrence risk of oral frailty.更多还原