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Risk Factor Analysis and Nomogram for Predicting In-Hospital Mortality in ICU Patients with Heat Stroke: A National
Lietao Wang1, Xin Fu1, Min He1
1Department of Critical Care Medicine, West China Hospital, Sichuan University, Chengdu, 610041, People's Republic of China.
Insights
This study identified creatinine, AST, and SBP as key risk factors for in-hospital mortality in heat stroke patients. A new nomogram aids in predicting mortality risk for better patient management.
Area of Science:
- Critical Care Medicine
- Environmental Health
- Clinical Prognostics
Background:
- Heat stroke is a severe condition requiring intensive care.
- Identifying mortality risk factors is crucial for effective management.
Purpose of the Study:
- To identify risk factors for in-hospital mortality in heat stroke patients admitted to ICUs.
- To develop and validate a predictive nomogram for mortality risk.
Main Methods:
- Retrospective analysis of clinical data from 292 ICU heat stroke patients nationwide.
- Logistic regression to identify risk factors; nomogram construction and internal validation.
- Performance assessed using ROC curves, calibration plots, and decision curve analysis.
Main Results:
- Creatinine (Cr), aspartate aminotransferase (AST), and systolic blood pressure (SBP) were significant predictors of mortality.
- The developed nomogram demonstrated good discriminative ability (AUC 0.763 training, 0.739 validation) and calibration.
- Internal validation confirmed nomogram stability and reliability.
Conclusions:
- Key risk factors for in-hospital mortality in heat stroke patients were identified.
- The validated nomogram offers a tool for individualized mortality risk prediction in ICU settings.
- This tool can assist clinicians in assessing and managing heat stroke patients.
Objective:
The aim of this nationwide multicenter study was to ascertain the risk factors associated with in-hospital mortality in patients with heat stroke admitted to intensive care units (ICUs) and to develop a nomogram for prognostic prediction.
Methods:
A retrospective analysis was conducted on clinical data collected from ICU patients diagnosed with heat stroke across multiple centers nationwide. Univariate and multivariate logistic regression analyses were performed to identify significant risk factors for in-hospital mortality. Based on the results of the multivariate analysis, a nomogram was constructed to estimate the individualized probability of mortality. Internal validation of the nomogram was performed, and its performance was assessed using receiver operating characteristic (ROC) curves, calibration plots, and decision curve analysis (DCA).
Results:
A total of 292 ICU patients with heat stroke were included in this study. Three risk factors, namely Cr (creatinine), AST (aspartate aminotransferase), and SBP (systolic blood pressure), were found to be significantly associated with in-hospital mortality. These risk factors were incorporated into the nomogram, which exhibited good discriminative ability (area under the ROC curve of the training and validation cohorts were 0.763 and 0.739, respectively) and calibration. Internal validation and decision curve analysis confirmed the stability and reliability of the nomogram.
Conclusion:
This nationwide multicenter study identified key risk factors for in-hospital mortality in ICU patients with heat stroke. The developed nomogram provides an individualized prediction of mortality risk and can serve as a valuable tool for clinicians in the assessment and management of ICU patients with heat stroke.
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