基于预测模型预测败血症患者28天死亡率:一项回顾性队列研究

IF 1.5 4区 医学 Q4 MEDICINE, RESEARCH & EXPERIMENTAL
Journal of International Medical Research Pub Date : 2025-08-01 Epub Date: 2025-07-31 DOI:10.1177/03000605251361104
Yi Sun, Tingting Wang, Mengna Zhang, Shuchen Cao, Liwei Hua, Kun Zhang
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引用次数: 0

摘要

目的:本研究旨在建立并验证一种预测重症监护病房脓毒症患者28天死亡率的nomogram模型。方法回顾性分析承德医科大学附属医院2022 ~ 2024年613例脓毒症患者的医疗保健记录。患者按7:3的比例随机分为训练组和测试组。采用最小绝对收缩和选择算子回归方法识别脓毒症的潜在预后因素,然后采用多因素logistic回归构建nomogram预测模型。通过受试者工作特征曲线、决策曲线分析和校准曲线对所建立模型的预测性能进行评价。结果血小板分布宽度与计数比、平均血小板体积、n端b型利钠肽水平、乳酸水平、呼吸道感染、糖尿病等因素均为预测因素。训练集中nomogram模型的受试者工作特征曲线下面积为0.907,灵敏度为0.846,特异度为0.831。标定曲线表明,预测结果与实际结果一致。决策曲线分析表明,该模型在实际应用中具有良好的鲁棒性。结论血小板分布宽度与计数比、平均血小板体积、n端b型利钠肽水平、乳酸水平、呼吸道感染、糖尿病与脓毒症密切相关。基于这六个变量的nomogram模型显示出了显著的预测性能,可以帮助临床医生识别高危患者并优化个性化治疗。
本文章由计算机程序翻译,如有差异,请以英文原文为准。

Prediction of 28-day mortality in patients with sepsis based on a predictive model: A retrospective cohort study.

Prediction of 28-day mortality in patients with sepsis based on a predictive model: A retrospective cohort study.

Prediction of 28-day mortality in patients with sepsis based on a predictive model: A retrospective cohort study.

Prediction of 28-day mortality in patients with sepsis based on a predictive model: A retrospective cohort study.

ObjectiveThis study aimed to develop and validate a nomogram model for predicting 28-day mortality in patients with sepsis in the intensive care unit.MethodsThe health care records of 613 patients with sepsis who were hospitalized at the Affiliated Hospital of Chengde Medical University from 2022 to 2024 were retrospectively reviewed. Patients were randomly divided into training and testing sets in a 7:3 ratio. The least absolute shrinkage and selection operator regression method was used to identify potential prognostic factors for sepsis, followed by multivariate logistic regression to construct a nomogram prediction model. The predictive performance of the developed model was evaluated via receiver operating characteristic curves, decision curve analysis, and calibration curves.ResultsThe predictive factors included the platelet distribution width to count ratio, mean platelet volume, N-terminal proB-type natriuretic peptide level, lactate level, respiratory tract infections, and diabetes. The area under the receiver operating characteristic curve for the nomogram model in the training set was 0.907, with sensitivity and specificity values of 0.846 and 0.831, respectively. The calibration curve demonstrated that the prediction results were consistent with the actual findings. Decision curve analysis revealed that the model showed robust performance in practical applications.ConclusionsPlatelet distribution width to count ratio, mean platelet volume, N-terminal proB-type natriuretic peptide level, lactate level, respiratory tract infection, and diabetes are closely associated with sepsis. A nomogram model based on these six variables demonstrates remarkable predictive performance and may assist clinicians in identifying high-risk patients and optimizing personalized therapy.

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来源期刊
CiteScore
3.20
自引率
0.00%
发文量
555
审稿时长
1 months
期刊介绍: _Journal of International Medical Research_ is a leading international journal for rapid publication of original medical, pre-clinical and clinical research, reviews, preliminary and pilot studies on a page charge basis. As a service to authors, every article accepted by peer review will be given a full technical edit to make papers as accessible and readable to the international medical community as rapidly as possible. Once the technical edit queries have been answered to the satisfaction of the journal, the paper will be published and made available freely to everyone under a creative commons licence. Symposium proceedings, summaries of presentations or collections of medical, pre-clinical or clinical data on a specific topic are welcome for publication as supplements. Print ISSN: 0300-0605
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