老年急性肺损伤患者列线图预后模型的构建  

Development of a nomogram to predict the mortality risk in elderly patients with acute lung injury

作　　者：陈婵[1] 梁飞宇[1] 张静[1] 杨静雯 施璇 杜晓红[1] 苏华芳[2] CHEN Chan;LIANG Feiyu;ZHANG Jing;YANG Jingwen;SHI Xuan;DU Xiaohong;SU Huafang(Department of Geriatrics,the First Affiliated Hospital of Wenzhou Medical University,Wenzhou 325015,China;Department of Radiotherapy and Chemotherapy,the First Affiliated Hospital of Wenzhou Medical University,Wenzhou 325015,China)

机构地区：[1]温州医科大学附属第一医院老年病科,浙江温州325015 [2]温州医科大学附属第一医院放化疗科,浙江温州325015

出　　处：《温州医科大学学报》2021年第6期449-453,共5页Journal of Wenzhou Medical University

基　　金：国家自然科学基金资助项目(81701379);浙江省自然科学基金资助项目(LQ17H010004)。

摘　　要：目的:探讨影响老年急性肺损伤(ALI)患者预后的独立危险因素,建立预测其死亡风险的列线图模型。方法:分别收集MIMIC-III数据库325例与温州医科大学附属第一医院138例ALI患者临床资料,采用单因素、多因素logistic回归分析筛选出预测死亡的危险因素,并构建预测短期可能死亡的列线图模型。结果:多因素logistic回归分析发现入院首日最低收缩压降低、血乳酸和凝血酶原时间(PT)升高等均为老年ALI患者死亡危险因素(均P<0.05);通过上述变量构建列线图模型,内部验证列线图ROC曲线下面积(AUC)为0.712(95%CI=0.656~0.767),外部验证列线图AUC为0.753(95%CI=0.671~0.836),内部与外部校准曲线均接近标准曲线。结论:本列线图模型可用于老年ALI患者预后评估,且具有良好的校准度与区分度。Objective:To explore the independent risk factors in the prognosis of elderly patients with acute lung injury(ALI)and to develop a nomogram to predict their mortality risk.Methods:Clinical data of 325 patients with acute lung injury from MIMIC-III database and 138 ALI cases in the First Affiliated Hospital of Wenzhou Medical University were collected.Univariate and multivariate logistic regression analyses were used to screen out the risk factors for death,and a nomogram model was constructed to predict short-term possible death.Results:Multivariate logistic regression analysis showed that the lowest systolic blood pressure,lactic acid and PT were risk factors for death in elderly patients with acute lung injury(P<0.05).The C index of nomogram model was 0.712(95%CI=0.656-0.767),and the C index of external validation nomogram was 0.753(95%CI=0.671-0.836),with the internal and external calibration curves close to the standard curve.Conclusion:This nomogram model can be used to evaluate the prognosis of elderly patients with acute lung injury,and has good accuracy and differentiation.

关 键 词：老年 急性肺损伤 死亡风险 列线图 

分 类 号：R563.8[医药卫生—呼吸系统]