Development of a risk-prediction nomogram for in-hospital adverse cardiovascular events in acute cardiotoxic agents poisoning.

Q1 Environmental Science
Toxicology Reports Pub Date : 2024-11-20 eCollection Date: 2024-12-01 DOI:10.1016/j.toxrep.2024.101826
Heba I Lashin, Fatma M Elgazzar, Sara I El Sharkawy, Sally M Elsawaf, Zahraa Khalifa Sobh
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引用次数: 0

Abstract

Adverse cardiovascular events (ACVE) are serious sequelae of acute poisoning with cardiotoxic agents. They include shock, acute myocardial injury, ventricular dysrhythmias, and cardiac arrest. Early identification of high-risk patients could improve their prognosis. Therefore, this study developed a risk-prediction nomogram to assess the risk of ACVE in patients with acute cardiotoxicities. This prospective cohort study was conducted at Tanta University Poison Control Center, Tanta, Egypt, from April 2023 to March 2024. It included 186 patients with acute cardiotoxic agent poisoning. ACVE occurred in 36 % of patients and were significantly associated with ICU admission and mortality (P<0.001). A multivariable logistic regression model was generated that included six significant predictors; modified shock index (AOR of 6.431, 95 % CI: 1.361-30.398, P = 0.02), serum bicarbonate level (AOR of 0.747, 95 % CI: 0.661-0.843, P = 0.001), oxygen saturation (AOR of 0.867, 95 % CI: 0.810-0.929, P = 0.001), ST segment changes (AOR of 9.196, 95 % CI: 1.989-42.508, P = 0.011), prolonged QTc (AOR of 3.015, 95 % CI: 0.975-9.325, P = 0.044), and QRS width (AOR of 1.032, 95 % CI: 1.001-1.064, P = 0.009). The nomogram was statistically significant (P <0.001) and could predict ACVE with 89.2 % accuracy. A Receiver Operating Characteristics analysis was conducted to ensure the nomogram's discrimination ability (Area under the curve =0.956). Also, the calibration curve was drawn using the bootstrapping method to ensure the nomogram's internal validity. The current study provided an easily applicable nomogram that could accurately predict ACVE following acute cardiotoxicities, regardless of the causative agent.

急性心脏毒性药物中毒的院内不良心血管事件风险预测图的建立。
心血管不良事件(ACVE)是心脏毒性药物急性中毒的严重后遗症。它们包括休克、急性心肌损伤、室性心律失常和心脏骤停。早期发现高危患者可改善预后。因此,本研究开发了一种风险预测图来评估急性心脏毒性患者使用ACVE的风险。这项前瞻性队列研究于2023年4月至2024年3月在埃及坦塔大学毒物控制中心进行。包括186例急性心毒性药物中毒患者。ACVE发生在36% %的患者中,与ICU入院和死亡率(PP = 0.02)、血清碳酸氢浓度(AOR为0.747,95 % CI: 0.661-0.843, P = 0.001)、血氧饱和度(AOR为0.867,95 % CI: 0.810-0.929, P = 0.001)、ST段改变(AOR为9.196,95 % CI: 1.989-42.508, P = 0.011)、QTc延长(AOR为3.015,95 % CI: 0.975-9.325, P = 0.044)、QRS宽度(AOR为1.032,95 % CI: 1.001-1.064, P = 0.009)显著相关。nomogram统计学差异有统计学意义(P
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Toxicology Reports
Toxicology Reports Environmental Science-Health, Toxicology and Mutagenesis
CiteScore
7.60
自引率
0.00%
发文量
228
审稿时长
11 weeks
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