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The Development and Validation of a Nomogram for Predicting Sepsis Risk in Diabetic Patients with Urinary Tract
Hua-Qiao Tan1,2, Xiang-Jie Duan3, Wan Qu4
1Department of Epidemiology, School of Public Health, Sun Yat-Sen University, Guangzhou 510080, China.
Medicina (Kaunas, Lithuania)
|February 26, 2025
Summary
Diabetic patients with urinary tract infections (UTI) face a high risk of sepsis. This study developed a nomogram using nine factors to predict sepsis risk in these patients, aiding clinical management.
Area of Science:
- Urology
- Diabetology
- Critical Care Medicine
Background:
- Urinary tract infection (UTI) is a frequent comorbidity in diabetic patients.
- UTI in diabetic patients is a significant cause of sepsis.
- Developing predictive tools for sepsis in this population is crucial.
Purpose of the Study:
- To develop and validate a nomogram for predicting the risk of sepsis in diabetic patients with UTI (DPUTIs).
- To identify independent prognostic factors for sepsis risk in DPUTIs.
Main Methods:
- Retrospective observational study using data from the MIMIC-IV database.
- Development of a nomogram based on LASSO and multivariate logistic regression.
- Validation of the nomogram using AUC, NRI, IDI, calibration curves, and DCA.
Main Results:
- Nine independent prognostic factors identified: urine RBC classification, urine WBC classification, blood glucose, age, temperature, WBCs, SOFA score, lymphocytes, and hematocrit.
- The nomogram demonstrated robust discrimination and good calibration.
- Decision curve analysis indicated favorable clinical utility.
Conclusions:
- The developed nomogram effectively predicts sepsis risk in DPUTIs.
- This tool can assist clinicians in optimizing the management of at-risk diabetic patients with UTI.
- Provides evidence-based support for early intervention and risk factor management.
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