开发和验证一个名谱来预测感染性心力衰竭患者在重症监护病房的存活率
Tong Tong1,2, Yikun Guo2,3, Qingqing Wang1
1Guang'anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, China.
Scientific reports
|January 6, 2025
概括
这项研究开发了一种名谱,用于预测心力衰竭的败血症患者的生存率. 该模型使用临床数据来估计7,15,30天的生存概率,有助于更好地管理患者.
科学领域:
- 关键护理医学 关键护理医学
- 心脏病学 心脏病学
- 生物统计学 生物统计学
背景情况:
- 败血症经常复杂心力衰竭,增加死亡风险.
- 对心力衰竭的败血症患者的预测工具对于及时干预至关重要.
研究的目的:
- 开发和验证一个名谱模型,用于预测患有败血症和心力衰竭的重症监护病房 (ICU) 患者的短期存活率 (7,15,30天).
- 确定影响该患者队列预后的关键临床因素.
主要方法:
- 来自MIMIC-IV数据库的5490名患者的回顾性分析.
- 使用考克斯比例危险回归在训练组 (70%) 和测试组 (30%) 上的验证来开发名录 (30%).
- 使用一致性指数 (C指数),ROC曲线,校准图和决策曲线分析 (DCA) 评估模型性能.
主要成果:
- 创建了一个包含13个变量 (年龄,肺炎,机械通风,K,AG,Lac,APTT,WBC,RDW,HRR,SOFA,CCI) 的名图.
- 该模型表现出强大的预测准确性,C指数为0.730 (训练) 和0.761 (测试).
- 验证证实了nomogram的可靠性和临床实用性,用于生存预测.
结论:
- 一个实用的名图有效地预测了患有败血症和心力衰竭的ICU患者的短期生存率.
- 该模型可以通过突出显著的风险因素来指导治疗策略,从而有可能改善患者的治疗结果.
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