Development and external-validation of a nomogram for predicting the survival of hospitalized HIV/AIDS patients based on a large study cohort in western China
Development and external-validation of a nomogram for predicting the survival of hospitalized HIV/AIDS patients based on a large study cohort in western China
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基于中国西部的大型研究队列，用于预测住院艾滋病毒/艾滋病患者生存率的列线图的开发和外部验证
DOI：
10.1017/s0950268820000758
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发表时间：
2020
影响因子：
4.2
通讯作者：
L.Ye
中科院分区：
文献类型：
--
作者：
Z.Yuan;B.Zhou;S.Meng;J.Jiang;S.Huang;X.Lu;N.Wu;Z.Xie;J.Deng;X.Chen;J.Liu;J.Zhang;F.Wu;H.Liang;L.Ye
这项研究的目的是开发和外部验证一种简单易用的诺模图，用于预测住院的人类免疫缺陷病毒/获得性免疫缺陷综合征(HIV/AIDS)患者(HIV/AIDS住院患者)的存活率。2012年1月至2014年12月期间住院的PLWHA(n=3724)被纳入培训队列。2015年收治的HIV感染住院患者(n=1987)被纳入外部验证队列。使用最小绝对收缩和选择算子方法进行数据降维，选择最优预测因子。该图包含了11个独立的预测因素，包括职业、抗逆转录病毒治疗、肺炎、结核病、马尔尼菲杆菌、高血压、败血症、贫血、呼吸衰竭、低蛋白血症和电解质紊乱。模型的似然χ2统计量为516.30(P=0.000)。在10天和20天的时间点上，综合布赖尔得分为0.076，诺模图的布赖尔得分分别为0.046和0.071。受试者工作特性曲线下面积在两个时间点分别为0.819和0.828，精确召回曲线分别为0.242和0.378。两套系统的校正曲线和决策曲线分析表明，诺模图具有良好的性能和较高的净效益。综上所述，本研究开发的诺模图具有较高的校正度，具有临床应用价值。它为及时的临床决策和住院的PLWHA的风险管理提供了一个方便和有用的工具。
The aim of this study was to develop and externally validate a simple-to-use nomogram for predicting the survival of hospitalised human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS) patients (hospitalised person living with HIV/AIDS (PLWHAs)). Hospitalised PLWHAs (n = 3724) between January 2012 and December 2014 were enrolled in the training cohort. HIV-infected inpatients (n = 1987) admitted in 2015 were included as the external-validation cohort. The least absolute shrinkage and selection operator method was used to perform data dimension reduction and select the optimal predictors. The nomogram incorporated 11 independent predictors, including occupation, antiretroviral therapy, pneumonia, tuberculosis, Talaromyces marneffei, hypertension, septicemia, anaemia, respiratory failure, hypoproteinemia and electrolyte disturbances. The Likelihood χ2 statistic of the model was 516.30 (P = 0.000). Integrated Brier Score was 0.076 and Brier scores of the nomogram at the 10-day and 20-day time points were 0.046 and 0.071, respectively. The area under the curves for receiver operating characteristic were 0.819 and 0.828, and precision-recall curves were 0.242 and 0.378 at two time points. Calibration plots and decision curve analysis in the two sets showed good performance and a high net benefit of nomogram. In conclusion, the nomogram developed in the current study has relatively high calibration and is clinically useful. It provides a convenient and useful tool for timely clinical decision-making and the risk management of hospitalised PLWHAs.