Development and Validation of a Prognostic Nomogram to Predict 30-Day Mortality Risk in Patients with Sepsis-Induced Cardiorenal Syndrome.
Development and Validation of a Prognostic Nomogram to Predict 30-Day Mortality Risk in Patients with Sepsis-Induced Cardiorenal Syndrome.
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开发和验证用于预测脓毒症引起的心肾综合征患者 30 天死亡风险的预后列线图
DOI：
10.1159/000524483
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发表时间：
2022-07
期刊：
影响因子：
--
通讯作者：
中科院分区：
文献类型：
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作者：
脓毒症诱导的心脏肾综合征是一种破坏性的疾病，常常与高病死率相关。在这项研究中，我们的目标是开发一个个性化的正常图，可以帮助临床医生评估被诊断为脓毒症诱发的CRS患者的30天死亡风险。以上海同济医院2015年1月至2019年5月收治的340例败血症CRS患者为训练队列，建立诺模图预后模型。该模型是使用多变量Logistic分析构建的，然后由2019年6月至2020年12月期间103名被诊断为脓毒症诱发CRS的独立队列患者进行外部验证。通过辨别、校准和准确性来评估诺模图的预后能力。五个预后因素被确定并包括在诺模图中：年龄、序贯(败血症相关)器官衰竭评估(SOFA)评分、血管加压药、基线血肌酐和肌红蛋白变化率。我们的预测诺模图显示了很好的校准曲线，在模型开发和验证中，曲线下的面积分别为0.879和0.912，具有很强的区分力。此外，诺模图预测模型的预测准确率明显高于SOFA评分。我们开发了脓毒症诱发CRS患者的预后诺模图模型，并在另一独立队列中对该模型进行了外部验证。与SOFA评分相比，诺模图在预测30天死亡风险方面显示出更大的力量，这可能有助于临床医生估计短期预后和调整治疗策略。
Sepsis-induced cardiorenal syndrome (sepsis-induced CRS) is a devastating medical condition that is frequently associated with a high fatality rate. In this study, we aimed to develop an individualized nomogram that may help clinicians assess 30-day mortality risk in patients diagnosed with sepsis-induced CRS. A total of 340 patients with sepsis-induced CRS admitted from January 2015 to May 2019 in Shanghai Tongji Hospital were used as a training cohort to develop a nomogram prognostic model. The model was constructed using multivariable logistic analyses and was then externally validated by an independent cohort of 103 patients diagnosed with sepsis-induced CRS from June 2019 to December 2020. The prognostic ability of the nomogram was assessed through discrimination, calibration, and accuracy. Five prognostic factors were determined and included in the nomogram: age, Sequential (sepsis-related) Organ Failure Assessment (SOFA) score, vasopressors, baseline serum creatinine, and the rate of change in myoglobin. Our prognostic nomogram showed well-fitted calibration curves and yielded strong discrimination power with the area under the curve of 0.879 and 0.912 in model development and validation, respectively. In addition, the nomogram prognostic model exhibited an evidently higher predictive accuracy than the SOFA score. We developed a prognostic nomogram model for patients with sepsis-induced CRS and externally validated the model in another independent cohort. The nomogram exhibited greater strength in predicting 30-day mortality risk than the SOFA score, which may help clinicians estimate short-term prognosis and modulate therapeutic strategies.
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DOI：
10.1186/cc11454
发表时间：
2013-02-04
期刊：
Critical care (London, England)
影响因子：
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作者：
Kellum JA;Lameire N;KDIGO AKI Guideline Work Group
通讯作者：
KDIGO AKI Guideline Work Group
SOFA 评分和尿液 NGAL 的结合可能是危重手术患者呼吸机依赖的有效预测因子：一项试点研究。
DOI：
10.3390/diagnostics11071186
发表时间：
2021-06-30
期刊：
Diagnostics (Basel, Switzerland)
影响因子：
--
作者：
Tsai HI;Lu YC;Kou HW;Hsu HY;Huang SF;Huang CW;Lee CW
通讯作者：
Lee CW
DOI：
10.1186/s13054-016-1218-4
发表时间：
2016-03-15
期刊：
Critical care (London, England)
影响因子：
--
作者：
De Rosa S;Samoni S;Ronco C
通讯作者：
Ronco C
影响因子：
158.5
作者：
Rivers, E;Nguyen, B;Tomlanovich, M
通讯作者：
Tomlanovich, M
影响因子：
8.8
作者：
Roberts, Russel J.;Miano, Todd A.;Lat, Ishaq
通讯作者：
Lat, Ishaq