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. 2024 Jul 1:17:2299-2309.
doi: 10.2147/JPR.S466939. eCollection 2024.

A Prognostic Model Incorporating Relevant Peripheral Blood Inflammation Indicator to Predict Postherpetic Neuralgia in Patients with Acute Herpes Zoster

Meng Cai #  1 , Jing Yin #  1 , YongFen Zeng  1 , HongJun Liu  1 , Yi Jin  1
Affiliations

A Prognostic Model Incorporating Relevant Peripheral Blood Inflammation Indicator to Predict Postherpetic Neuralgia in Patients with Acute Herpes Zoster

Meng Cai et al. J Pain Res. .

Abstract

Objective: To determine the risk of postherpetic neuralgia (PHN) in patients with acute herpes zoster (HZ), this study developed and validated a novel clinical prediction model by incorporating a relevant peripheral blood inflammation indicator.

Methods: Between January 2019 and June 2023, 209 patients with acute HZ were categorized into the PHN group (n = 62) and the non-PHN group (n = 147). Univariate and multivariate logistic regression analyses were conducted to identify risk factors serving as independent predictors of PHN development. Subsequently, a nomogram prediction model was established, and the discriminative ability and calibration were evaluated using the receiver operating characteristic curve, calibration plots, and decision curve analysis (DCA). The nomogram model was internally verified through the bootstrap test method.

Results: According to univariate logistic regression analyses, five variables, namely age, hypertension, acute phase Numeric Rating Scale (NRS-11) score, platelet-to-lymphocyte ratio (PLR), and systemic immune inflammation index, were significantly associated with PHN development. Multifactorial analysis further unveiled that age (odds ratio (OR) [95% confidence interval (CI)]: 2.309 [1.163-4.660]), acute phase NRS-11 score (OR [95% CI]: 2.837 [1.294-6.275]), and PLR (OR [95% CI]: 1.015 [1.010-1.022]) were independent risk factors for PHN. These three predictors were integrated to establish the prediction model and construct the nomogram. The area under the receiver operating characteristic curve (AUC) for predicting the PHN risk was 0.787, and the AUC of internal validation determined using the bootstrap method was 0.776. The DCA and calibration curve also indicated that the predictive performance of the nomogram model was commendable.

Conclusion: In this study, a risk prediction model was developed and validated to accurately forecast the probability of PHN after HZ, thereby demonstrating favorable discrimination, calibration, and clinical applicability.

Keywords: nomogram; platelet-to-lymphocyte ratio; postherpetic neuralgia; risk factors.

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Conflict of interest statement

The authors declared no potential conflicts of interest in this work.

Figures

Figure 1
Figure 1
Flowchart depicting the study protocol.
Figure 2
Figure 2
Representatives of nomogram prediction model (A) and dynamic nomogram (B).
Figure 3
Figure 3
Receiver operating characteristic curve (ROC) for the discrimination of the predictive model (A) and internal verification model (B).
Figure 4
Figure 4
Calibration curves of the predictive PHN risk nomogram.
Figure 5
Figure 5
Decision curve analysis (DCA) of the predictive PHN risk nomogram.
See this image and copyright information in PMC

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