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Related Experiment Video

Updated: Jun 24, 2025

Establishing a Competing Risk Regression Nomogram Model for Survival Data
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A nomogram predicting pneumonia after cardiac surgery: a retrospective modeling study.

Kuo Wang1, Hai-Tao Zhang2, Fu-Dong Fan3

  • 1Department of Cardio-Thoracic Surgery, Nanjing Drum Tower Hospital,Affiliated Clinical College of Xuzhou Medical University, Nanjing, 210008, Jiangsu, China.

Journal of Cardiothoracic Surgery
|June 1, 2024
PubMed
Summary

Postoperative pneumonia is a common risk after cardiac surgery. This study identified key risk factors and developed a nomogram to predict and reduce pneumonia incidence, improving patient outcomes.

Keywords:
Cardiac surgeryNomogramOutcomesPostoperative pneumonia

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Area of Science:

  • Cardiothoracic Surgery
  • Infectious Diseases
  • Medical Informatics

Background:

  • Postoperative pneumonia (POP) is the most frequent nosocomial infection following cardiac surgery.
  • Identifying predictive factors for POP is crucial for patient management and outcomes.

Purpose of the Study:

  • To identify independent risk factors for the development of POP after cardiac surgery.
  • To construct and validate a predictive nomogram for POP in this patient population.

Main Methods:

  • Retrospective analysis of clinical data from 1188 cardiac surgery patients (October 2020 - September 2021).
  • Logistic regression analysis to determine independent risk factors for POP.
  • Development and validation of a nomogram using identified risk factors, assessed by AUC and calibration plots.

Main Results:

  • Key independent risk factors identified: age (>55), preoperative malnutrition, diabetes mellitus, prolonged cardiopulmonary bypass (CPB) time (>135 min), moderate to severe ARDS, use of ECMO/IABP/CRRT, and prolonged mechanical ventilation (MV) (>20 hours).
  • The developed nomogram demonstrated good discrimination (AUC = 0.82) and calibration.
  • The nomogram effectively predicts the likelihood of POP based on identified risk factors.

Conclusions:

  • A facile and effective nomogram for predicting POP after cardiac surgery has been developed.
  • The nomogram exhibits good predictive performance (discrimination and calibration).
  • This tool can aid in identifying modifiable risk factors, potentially reducing POP incidence and patient mortality.