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A multifactor model for predicting mortality in critically ill patients: A multicenter prospective cohort study
Zhongwang Li1, Baoli Cheng1, Jingya Wang1
1Department of Anesthesiology and Intensive Care Unit, The First Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, Zhejiang, PR China.
Purpose:
The objective of this study was to develop a model using a combination of routine clinical variables to predict mortality in critically ill patients.
Methods:
A cohort of 500 patients recruited from eight university hospital intensive care units (ICUs) was used to develop a model via logistic regression analyses. Discrimination and calibration analyses were performed to assess the model.
Results:
The model included the lactate level (odds ratio [OR]=1.11, 95% confidence interval [CI] 1.01 to 1.22, P=0.029), neutrophil-to-lymphocyte ratio (OR=1.03, 95% CI 1.01 to 1.04, P=0.002), acute physiology score (OR=1.11, 95% CI 1.06 to 1.15, P<0.001), Charlson comorbidity index (OR=1.36, 95% CI 1.15 to 1.60, P<0.001) and surgery type (OR: selective=Ref, no surgery=8.04, 95% CI 3.74 to 17.30, P<0.001, emergency=3.66, 95% CI 1.60 to 8.36, P=0.002). The model showed good discrimination (area under receiver operating characteristic curve: 0.84, 95% CI: 0.80 to 0.87) and calibration (Hosmer-Lemeshow test P=0.137) for predicting in-hospital mortality.
Conclusion:
The developed multifactor model can be used to effectively predict mortality in critically ill patients at ICU admission.
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