老年COPD急性加重期并发急性左心衰竭的风险预测列线图模型构建及预防建议  

Construction of risk prediction nomogram model and prevention suggestions for elderly patients with acute exacerbation of COPD complicated with acute left ventricular failure

作　　者：陈勇 季曼曼 CHEN Yong;JI Manman(Affiliated Central Hospital of Jiangnan University,Jiangsu 214000 China)

机构地区：[1]江南大学附属中心医院,214000

出　　处：《全科护理》2024年第3期416-420,共5页Chinese General Practice Nursing

摘　　要：目的:构建老年慢性阻塞性肺疾病(COPD)急性加重期并发急性左心衰竭的风险预测列线图模型,提出预防建议。方法:回顾性分析2020年6月—2022年7月医院收治的259例老年COPD急性加重期病人的临床资料,根据病人有无并发急性左心衰竭将其分为并发组和未并发组,采用多因素Logistic回归分析法分析老年COPD急性加重期并发急性左心衰竭的危险因素,并构建风险预测列线图模型。结果:合并高血压、合并糖尿病、二氧化碳分压增高、右心室舒张末期内径均是老年COPD急性加重期病人并发急性左心衰竭的危险因素(P<0.05),白蛋白、氧分压、左心室内径缩短率是其保护因素(P<0.05);基于以上7项影响因素构建风险预测列线图模型,受试者工作特征曲线显示该模型预测的曲线下面积为0.849[95%CI(0.781,0.916)],校准曲线与理想曲线贴合良好,Hosmer-Lemeshow检验(P=0.440)。结论:整合老年COPD急性加重期并发急性左心衰竭的影响因素构建风险预测列线图模型具有良好的区分度和准确度,对临床评估、干预具有一定的指导价值。Objective:To construct a risk prediction nomogram model for elderly patients with acute exacerbation of chronic obstructive pulmonary disease(COPD)complicated by acute left ventricular failure,and to provide prevention recommendations.Methods:The clinical data of 259 elderly patients with acute exacerbation of COPD admitted to the hospital from June 2020 to July 2022 were retrospectively analyzed.The patients were divided into concurrent group and non-complicated group according to whether they complicated with acute left heart failure.The multivariate logistic regression analysis method was used to analyze the risk factors of acute left heart failure during acute exacerbation of COPD in the elderly,and a risk prediction nomogram model was constructed.Results:Comorbid hypertension,diabetes,increased partial pressure of carbon dioxide,and right ventricular end-diastolic diameter were all risk factors for acute left heart failure in elderly patients with acute exacerbation of COPD(P<0.05).Albumin,partial pressure of oxygen,and left ventricular inner diameter shortening rate were its protective factors(P<0.05).A risk prediction nomogram model was constructed based on the above 7 influencing factors.The receiver operating characteristic curve showed that the area under the curve predicted by the model was 0.849(95%CI was 0.781,0.916),and the calibration curve fits well with the ideal curve.The Hosmer-Lemeshow test showed P=0.440.Conclusions:Integrating the influencing factors of acute exacerbation of COPD complicated with acute left heart failure in the elderly to construct a risk prediction nomogram model has good differentiation and accuracy,and has certain guiding value for clinical evaluation and intervention.

关 键 词：慢性阻塞性肺疾病 急性左心衰竭 老年 列线图 

分 类 号：R473.5[医药卫生—护理学]