Nomograms for Predicting Coexisting Cardiovascular Disease and Prognosis in Chronic Obstructive Pulmonary Disease: A Study Based on NHANES Data.

IF 2.1 4区 医学 Q3 RESPIRATORY SYSTEM
Canadian respiratory journal Pub Date : 2022-06-09 eCollection Date: 2022-01-01 DOI:10.1155/2022/5618376
Yuanjie Qiu, Yan Wang, Nirui Shen, Qingting Wang, Limin Chai, Jian Wang, Qianqian Zhang, Yuqian Chen, Jin Liu, Danyang Li, Huan Chen, Manxiang Li
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引用次数: 3

Abstract

Background: Chronic obstructive pulmonary disease (COPD) is a common chronic disease. Progression is further exacerbated by the coexistence of cardiovascular disease (CVD). We aim to construct a diagnostic nomogram for predicting the risk of coexisting CVD and a prognostic nomogram for predicting long-term survival in COPD.

Methods: The 540 eligible participants selected from the NHANES 2005-2010 were included in this study. Logistic regression analysis was used to construct a diagnostic nomogram for the diagnosis of coexisting CVD in COPD. Cox regression analyses were used to construct a prognostic nomogram for COPD. A risk stratification system was developed based on the total score generated from the prognostic nomogram. We used C-index and ROC curves to evaluate the discriminant ability of the newly built nomograms. The models were also validated utilizing calibration curves. Survival curves were made using the Kaplan-Meier method and compared by the Log-rank test.

Results: Logistic regression analysis showed that gender, age, neutrophil, RDW, LDH, and HbA1c were independent predictors of coexisting CVD and were included in the diagnostic model. Cox regression analysis indicated that CVD, gender, age, BMI, RDW, albumin, LDH, creatinine, and NLR were independent predictors of COPD prognosis and were incorporated into the prognostic model. The C-index and ROC curves revealed the good discrimination abilities of the models. And the calibration curves implied that the predicted values by the nomograms were in good agreement with the actual observed values. In addition, we found that coexisting with CVD had a worse prognosis compared to those without CVD, and the prognosis of the low-risk group was better than that of the high-risk group in COPD.

Conclusions: The nomograms we developed can help clinicians and patients to identify COPD coexisting CVD early and predict the 5-year and 10-year survival rates of COPD patients, which has some clinical practical values.

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预测慢性阻塞性肺疾病并发心血管疾病和预后的nomogram:一项基于NHANES数据的研究
背景:慢性阻塞性肺疾病(COPD)是一种常见的慢性疾病。心血管疾病(CVD)的共存进一步加剧了进展。我们的目标是建立一个诊断图来预测并发心血管疾病的风险,以及一个预测慢性阻塞性肺病患者长期生存的预后图。方法:从NHANES 2005-2010中选取540名符合条件的受试者。采用Logistic回归分析构建COPD合并CVD的诊断图。采用Cox回归分析构建COPD的预后图。根据预后nomogram总评分,建立了风险分层系统。我们用c指数和ROC曲线来评价新建立的模态图的判别能力。利用标定曲线对模型进行了验证。生存曲线采用Kaplan-Meier法绘制,Log-rank检验比较。结果:Logistic回归分析显示,性别、年龄、中性粒细胞、RDW、LDH和HbA1c是合并CVD的独立预测因子,并被纳入诊断模型。Cox回归分析显示,CVD、性别、年龄、BMI、RDW、白蛋白、LDH、肌酐、NLR是COPD预后的独立预测因素,并被纳入预后模型。c指数和ROC曲线显示模型具有良好的判别能力。标定曲线表明,用模态图预测的值与实际观测值吻合较好。此外,我们发现合并CVD的COPD患者预后较不合并CVD的患者差,低危组预后优于高危组。结论:本研究建立的图可以帮助临床医生和患者早期识别COPD合并CVD,预测COPD患者的5年和10年生存率,具有一定的临床实用价值。
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来源期刊
Canadian respiratory journal
Canadian respiratory journal 医学-呼吸系统
CiteScore
4.20
自引率
0.00%
发文量
61
审稿时长
6-12 weeks
期刊介绍: Canadian Respiratory Journal is a peer-reviewed, Open Access journal that aims to provide a multidisciplinary forum for research in all areas of respiratory medicine. The journal publishes original research articles, review articles, and clinical studies related to asthma, allergy, COPD, non-invasive ventilation, therapeutic intervention, lung cancer, airway and lung infections, as well as any other respiratory diseases.
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