Development and Validation of a Nomogram for Predicting 28-Day Mortality on Admission in Elderly Patients with Severe Community-Acquired Pneumonia.
Development and Validation of a Nomogram for Predicting 28-Day Mortality on Admission in Elderly Patients with Severe Community-Acquired Pneumonia.
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DOI：
10.2147/jir.s369319
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发表时间：
2022
影响因子：
4.5
通讯作者：
中科院分区：
文献类型：
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老年重症社区获得性肺炎（SCAP）的死亡率研究较少。早期预测住院患者的28 d死亡率将有助于老年SCAP患者（年龄≥65岁）的临床管理，但目前仍缺乏可靠有效的预测模型。来自中国33家医院的292例老年SCAP患者符合美国胸科协会定义的标准。采用单因素和多因素Logistic回归分析对临床参数进行分析。构建了预测老年SCAP患者28天死亡率的列线图，并使用受试者工作特征曲线下面积（AUC）进行评估，并使用Bootstrap方法进行内部验证。共有292例老年患者（227例存活，65例在28天内死亡）被纳入分析。年龄、格拉斯哥评分、血小板和血尿素氮值与老年SCAP患者的28天死亡率显著相关。列线图的AUC为0.713，28天死亡率的校准曲线也显示预测和实际死亡概率之间具有高度一致性。本研究提供了一个包含年龄、格拉斯哥评分、血小板和血尿素氮值的列线图，可以方便地用于预测老年SCAP患者的28天死亡率。该模型有可能帮助临床医生评估SCAP患者的预后。
There were few studies on the mortality of severe community-acquired pneumonia (SCAP) in elderly people. Early prediction of 28-day mortality of hospitalized patients will help in the clinical management of elderly patients (age ≥65 years) with SCAP, but a prediction model that is reliable and valid is still lacking. The 292 elderly patients with SCAP met the criteria defined by the American Thoracic Society from 33 hospitals in China. Clinical parameters were analyzed by the use of univariable and multivariable logistic regression analysis. A nomogram to predict the 28-day mortality in elderly patients with SCAP was constructed and evaluated using the area under the receiver operating characteristic curve (AUC) and internally verified using the Bootstrap method. A total of 292 elderly patients (227 surviving and 65 died within 28 days) were included in the analysis. Age, Glasgow score, blood platelet, and blood urea nitrogen values were found to be significantly associated with 28-day mortality in elderly patients with SCAP. The AUC of the nomogram was 0.713 and the calibration curve for 28-day mortality also showed high coherence between the predicted and actual probability of mortality. This study provides a nomogram containing age, Glasgow score, blood platelet, and blood urea nitrogen values that can be conveniently used to predict 28-day mortality in elderly patients with SCAP. This model has the potential to assist clinicians in evaluating prognosis of patients with SCAP.