Factors associated with in-hospital mortality in acute exacerbations of COPD: a logistic regression and nomogram...

To explore the influencing factors of in-hospital mortality in patients with acute exacerbation of COPD (AECOPD).

Data of 425 patients with AECOPD were retrospectively collected and divided into a training set (n = 298) and a validation set (n = 127) at a ratio of 7:3. Risk factors for the death outcome were screened through univariate and multivariate logistic regression. A nomogram model was constructed, and the receiver operating characteristic curves (ROC) and calibration curves were plotted to evaluate the model's performance, which was then validated in the validation set. Decision curve analysis (DCA) was used to evaluate the clinical value.

Multivariate logistic regression showed that age, blood oxygen saturation, alanine aminotransferase, and C-reactive protein were independent influencing factors for in-hospital mortality (p < 0.05). The importance ranking was C-reactive protein > age > oxygen saturation > alanine aminotransferase. The nomogram showed good calibration and discrimination in both the training and validation sets. The area under the ROC curve (AUC) was 0.871 (95% CI: 0.803-0.940) in the training set and 0.867 (95% CI: 0.778-0.956) in the validation set. The sensitivity and specificity were 0.912, 0.754 in the training set and 0.818, 0.771 in the validation set.

The constructed model shows a promising association with in-hospital mortality in this single-center study, serving as a hypothesis-generating tool for risk stratification of patients with AECOPD.