A Nomogram for Predicting the Risk of Death in Patients with Prolonged Hospital Stays in Internal Medicine Wards: A Retrospective Study.

IF 2.1 4区医学 Q2 MEDICINE, GENERAL & INTERNAL

International Journal of General Medicine Pub Date : 2025-04-23 eCollection Date: 2025-01-01 DOI:10.2147/IJGM.S515677

Huiqing Pan, Xinran Liu, Bing Wang, Hua Hang, Sheng Ye

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引用次数: 0

Abstract

Objective: Prolonged hospital length of stay (PLOS) is associated with adverse outcomes, including increased healthcare costs, higher risk of complications, and increased mortality. This study aimed to investigate the relationship between PLOS and mortality among patients hospitalized in internal medicine wards and to develop a nomogram to predict the risk of death in this patient population.

Methods: This retrospective study included patients hospitalized for more than 30 days in internal medicine wards between January 1, 2022, and December 31, 2022. Multivariate logistic regression analysis was used to identify independent risk factors for in-hospital mortality. The nomogram was constructed based on the independent factors. Calibration curves and receiver operating characteristic (ROC) curves were used to evaluate the predictive performance of the nomogram, and decision curve analysis (DCA) was conducted to assess its clinical utility.

Results: A total of 1042 patients were included in this study, resulting in a mortality rate of 10.17%. Multivariate logistic regression analysis showed that age (OR=1.043, 95% CI: 1.026-1.061, P<0.001), tumor (OR=2.274, 95% CI: 1.441-3.589, P<0.001), blood transfusion (OR=4.667, 95% CI: 2.932-7.427, P<0.001), ADL score (OR=0.966, 95% CI: 0.952-0.981, P<0.001) and MNA-SF score (OR=0.825, 95% CI: 0.760-0.895, P<0.001) as independent risk factors for mortality among patients hospitalized in internal medicine wards. The nomogram constructed using these factors demonstrated well discriminatory ability, with an AUC of 0.803 (95% CI: 0.761-0.846). Decision curve analysis further validated the clinical utility of the nomogram, highlighting its potential to improve risk assessment and guide clinical decision-making.

Conclusion: This nomogram effectively evaluates the risk of death for prolonged hospitalization of patients in internal medicine wards and holds significant potential for promotion in clinical practice.

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预测内科病房长时间住院患者死亡风险的Nomogram：一项回顾性研究。

目的：延长住院时间（PLOS）与不良后果相关，包括医疗费用增加、并发症风险增加和死亡率增加。本研究旨在调查内科病房住院患者的PLOS与死亡率之间的关系，并开发一种nomographic来预测该患者群体的死亡风险。方法：回顾性研究纳入2022年1月1日至2022年12月31日在内科病房住院30天以上的患者。采用多因素logistic回归分析确定院内死亡的独立危险因素。基于独立因子构建了模态图。采用校准曲线和受试者工作特征（ROC）曲线评价nomogram预测能力，采用决策曲线分析（DCA）评价其临床应用价值。结果：本研究共纳入1042例患者，死亡率为10.17%。多因素logistic回归分析显示，年龄（OR=1.043, 95% CI: 1.026-1.061， POR=2.274, 95% CI: 1.441-3.589， POR=4.667, 95% CI: 2.932-7.427， POR=0.966, 95% CI: 0.952-0.981， POR=0.825, 95% CI: 0.76 -0.895， POR= 0.76 -0.895）可有效评价内科病房患者延长住院时间的死亡风险，具有临床推广潜力。

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

International Journal of General Medicine Medicine-General Medicine

自引率

0.00%

发文量

1113

审稿时长

16 weeks

期刊介绍： The International Journal of General Medicine is an international, peer-reviewed, open access journal that focuses on general and internal medicine, pathogenesis, epidemiology, diagnosis, monitoring and treatment protocols. The journal is characterized by the rapid reporting of reviews, original research and clinical studies across all disease areas. A key focus of the journal is the elucidation of disease processes and management protocols resulting in improved outcomes for the patient. Patient perspectives such as satisfaction, quality of life, health literacy and communication and their role in developing new healthcare programs and optimizing clinical outcomes are major areas of interest for the journal. As of 1st April 2019, the International Journal of General Medicine will no longer consider meta-analyses for publication.