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Predictive nomogram for 28-day mortality risk in mitral valve disorder patients in the intensive care unit: A

Yuxin Qiu1, Menglei Li2, Xiubao Song3

  • 1Department of Anesthesiology, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou 510080, China.

International Journal of Cardiology
|April 27, 2024
PubMed
Abstract

Insights

A new nomogram accurately predicts 28-day mortality in mitral valve disorder (MVD) patients by identifying key risk factors. This tool aids in improving patient prognosis and guiding early interventions like transcatheter mitral valve replacement.

Area of Science:

  • Cardiology
  • Medical Informatics
  • Predictive Analytics

Background:

  • Mitral valve disorder (MVD) is the most common valvular heart disease.
  • A validated clinical index for predicting MVD mortality is currently lacking.
  • Accurate mortality prediction is crucial for patient management and treatment decisions.

Purpose of the Study:

  • To develop and validate a nomogram for predicting 28-day mortality risk in MVD patients.
  • To identify independent risk factors associated with short-term mortality in MVD.
  • To compare the nomogram's performance against existing scoring systems.

Main Methods:

  • Utilized ICD-9 codes from the MIMIC-III database to identify MVD patients.
  • Employed LASSO and multivariate logistic regression to identify risk factors and construct the nomogram.
  • Assessed nomogram performance using AUC, calibration curves, Hosmer-Lemeshow test, IDI, NRI, and DCA.

Main Results:

  • Included 2771 MVD patients in the analysis.
  • Identified age, anion gap, creatinine, glucose, BUN, urine output, SBP, respiratory rate, SpO2, GCS, and metastatic cancer as independent risk factors.
  • The nomogram demonstrated adequate calibration and favorable discrimination, outperforming SAPSII, APSIII, and SOFA scores.

Conclusions:

  • Successfully developed a nomogram to predict 28-day mortality in MVD patients.
  • The nomogram identifies key independent risk factors, aiding in prognosis enhancement.
  • This tool can support decisions for early interventional treatments like TMVR and TMVI.
Keywords:
28-day mortalityMIMIC III databaseMitral valve disorderNomogramPrognosis

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