Development and validation of a nomogram to predict the mortality risk in elderly patients with ARF

PeerJ

Zhiliang Zhou¹  Junnan Xu¹  Zhiyi Wang²  Jie Weng²  Ruonan Hou²  Xiaoming Zhou²  Jingwen Yang³  Xuan Shi³  Chan Chen³ 

[1] Department of Emergency Medicine, The Second Affiliated Hospital and Yuying Children’s Hospital of Wenzhou Medical University, Wenzhou, China, China;Department of General Practice, The Second Affiliated Hospital and Yuying Children’s Hospital of Wenzhou Medical University, Wenzhou, China, China;Department of Geriatric Medicine, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China, China;

关键词: Acute respiratory failure;    Mortality risk;    Prognosis;    Nomogram;   

DOI  :  10.7717/peerj.11016

来源: DOAJ

【 摘 要 】

Background Acute respiratory failure (ARF) is a life-threatening complication in elderly patients. We developed a nomogram model to explore the risk factors of prognosis and the short-term mortality in elderly patients with ARF. Methods A total of 759 patients from MIMIC-III database were categorized into the training set and 673 patients from our hospital were categorized into the validation set. Demographical, laboratory variables, SOFA score and APS-III score were collected within the first 24 h after the ICU admission. A 30-day follow-up was performed for all patients. Results Multivariate logistic regression analysis showed that the heart rate, respiratoryrate, systolic pressure, SPO2, albumin and 24 h urine output were independent prognostic factors for 30-day mortality in ARF patients. A nomogram was established based on above independent prognostic factors. This nomogram had a C-index of 0.741 (95% CI [0.7058–0.7766]), and the C-index was 0.687 (95% CI [0.6458–0.7272]) in the validation set. The calibration curves both in training and validation set were close to the ideal model. The SOFA had a C-index of 0.653 and the APS-III had a C-index of 0.707 in predicting 30-day mortality. Conclusion Our nomogram performed better than APS-III and SOFA scores and should be useful as decision support on the prediction of mortality risk in elderly patients with ARF.

【 授权许可】

Unknown