Single-center nomogram model for sepsis complicated by acute lung injury

To construct and validate a nomogram model for predicting sepsis complicated by acute lung injury (ALI).

The healthcare records of 193 sepsis patients hospitalized at The Affiliated Tai'an City Central Hospital of Qingdao University from January 2022 to December 2023 were retrospectively reviewed. Among these patients, 69 were in the ALI group and 124 in the non-ALI group. A nomogram prediction model was constructed using logistic regression analysis. Its predictive performance was evaluated through various measures, including the area under the curve (AUC), calibration curve, decision curve, sensitivity, specificity, accuracy, recall rate, and precision rate.

The predictive factors included the neutrophil/lymphocyte ratio (NLR), oxygenation index (PaO₂/FiO₂), tumor necrosis factor-α (TNF-α), and acute physiology and chronic health evaluation II (APACHE II). The nomogram training set achieved an AUC of 0.959 (95% CI: 0.924-0.995), an accuracy of 92.59%, a recall of 96.70%, and a precision of 92.63%. In the validation set, the AUC was 0.938 (95% CI: 0.880-0.996), with an accuracy of 89.66%, a recall of 93.94%, and a precision of 88.57%. The calibration curve demonstrated that the prediction results were consistent with the actual findings. The decision curve indicated that the model has clinical applicability.

NLR, PaO₂/FiO₂, TNF-α, and APACHE II are closely associated with ALI in sepsis patients. A nomogram model based on these four variables shows strong predictive performance and may be used as a clinical decision-support tool to help physicians better identify high-risk groups.