Development and validation of a nomogram to predict mortality of patients with DIC in ICU

Qingbo Zeng ^1,2, Qingwei Lin ¹, Lincui Zhong ¹

⁰Intensive Care Unit, The 908th Hospital of Chinese PLA Logistic Support Force, Nanchang, China.

Frontiers in Medicine +

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July 24, 2024

View abstract on PubMed

Summary

This study developed a predictive nomogram for short-term mortality in disseminated intravascular coagulation (DIC) patients. The Lasso-Cox model identifies key risk factors, offering reliable, individualized risk predictions for critically ill patients.

Area Of Science

Critical Care Medicine
Hematology
Biostatistics

Background

Disseminated intravascular coagulation (DIC) is a severe condition associated with high mortality in critically ill patients.
Predictive models for short-term mortality in DIC patients are scarce.
Identifying risk factors is crucial for improving patient outcomes.

Purpose Of The Study

To identify risk factors associated with short-term mortality in overt DIC.
To construct a predictive nomogram for DIC mortality risk.
To provide individualized and reliable mortality risk assessments.

Main Methods

A total of 676 overt DIC patients were included.
A Cox proportional hazards regression model was developed using variables selected by LASSO regression.
Model performance was validated across MIMIC-III, MIMIC-IV, and the 908th Hospital databases.

Main Results

The predictive model incorporated heart failure, sepsis, height, SBP, lactate, HCT, PLT, INR, AST, and norepinephrine use.
The model achieved a C-index >0.65 across validation datasets, demonstrating good predictive performance at 7 and 28 days.
A nomogram was developed, showing superior net benefits in decision curve analysis.

Conclusions

A Lasso-Cox regression-based nomogram provides a tool for predicting short-term mortality in overt DIC.
The nomogram offers individualized and reliable risk stratification for critically ill DIC patients.
This tool can aid in clinical decision-making and patient management.

Keywords:

Lasso-Cox regression disseminated intravascular coagulation intensive care unit nomogram prediction short-term mortality