Development and Validation of Nomogram Models for Postoperative Pneumonia in Adult Patients Undergoing Elective Cardiac Surgery.
Development and Validation of Nomogram Models for Postoperative Pneumonia in Adult Patients Undergoing Elective Cardiac Surgery.
复制标题
接受择期心脏手术的成人患者术后肺炎列线图模型的开发和验证
DOI：
10.3389/fcvm.2021.750828
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发表时间：
2021
影响因子：
3.6
通讯作者：
Du X
中科院分区：
文献类型：
--
作者：
Wang D;Chen X;Wu J;Le S;Xie F;Li X;Wang H;Huang X;Zhang A;Du X
背景：术后肺炎(POP)是心脏手术后常见的并发症，与增加的发病率、死亡率和医疗费用有关。本研究的目的是调查成人择期心脏手术中与POP相关的危险因素，并建立和验证诺模图模型。方法：我们在中国的四个心脏中心进行了多中心的回顾性研究。2016年至2020年期间接受择期心内直视手术的成年人包括在内。患者按7：3的比例随机分配到训练集和验证集。收集并分析人口统计学、合并症、实验室数据、手术因素和术后结果。通过单因素和多因素分析确定POP的危险因素。在多元Logistic回归模型的基础上构建了诺模图，并通过校准、判别和决策曲线分析进行了评估。结果：共纳入13380名符合标准的患者，其中882名患者(6.6%)发展为POP。死亡率为2.0%，但在POP患者中显著增加(25.1%vs.0.4%，P<；0.001)。利用术前和术中变量，我们构建了基于10个独立危险因素的全诺模图模型和基于8个术前因素的术前诺模图模型。这两张诺模图都显示了良好的校准和辨别能力，并得到了很好的验证。决策曲线显示了显著的临床应用价值。最后，为了更好地应用于临床，定义了四个风险区间。结论：我们利用术前和术中因素建立并验证了心脏择期手术后POP的两个诺模图模型，这可能有助于个体化风险评估和预防决策。
Background: Postoperative pneumonia (POP) is a frequent complication following cardiac surgery, related to increased morbidity, mortality and healthcare costs. The objectives of this study were to investigate the risk factors associated with POP in adults undergoing elective cardiac surgery and to develop and validate nomogram models. Methods: We conducted a multicenter retrospective study in four cardiac centers in China. Adults operated with elective open-heart surgery from 2016 to 2020 were included. Patients were randomly allocated to training and validation sets by 7:3 ratio. Demographics, comorbidities, laboratory data, surgical factors, and postoperative outcomes were collected and analyzed. Risk factors for POP were identified by univariate and multivariate analysis. Nomograms were constructed based on the multivariate logistic regression models and were evaluated with calibration, discrimination and decision curve analysis. Results: A total of 13,380 patients meeting the criteria were included and POP developed in 882 patients (6.6%). The mortality was 2.0%, but it increased significantly in patients with POP (25.1 vs. 0.4%, P < 0.001). Using preoperative and intraoperative variables, we constructed a full nomogram model based on ten independent risk factors and a preoperative nomogram model based on eight preoperative factors. Both nomograms demonstrated good calibration, discrimination, and were well validated. The decision curves indicated significant clinical usefulness. Finally, four risk intervals were defined for better clinical application. Conclusions: We developed and validated two nomogram models for POP following elective cardiac surgery using preoperative and intraoperative factors, which may be helpful for individualized risk evaluation and prevention decisions.
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影响因子：
2.5
作者：
He, Siyi;Wu, Fan;Zhang, Jinbao
通讯作者：
Zhang, Jinbao
DOI：
10.1093/cid/ciy543
发表时间：
2019-01-18
期刊：
Clinical infectious diseases : an official publication of the Infectious Diseases Society of America
影响因子：
--
作者：
Bonell A;Azarrafiy R;Huong VTL;Viet TL;Phu VD;Dat VQ;Wertheim H;van Doorn HR;Lewycka S;Nadjm B
通讯作者：
Nadjm B
影响因子：
--
作者：
Anastasiadis, Kyriakos;Murkin, John;Carrel, Thierry
通讯作者：
Carrel, Thierry
DOI：
10.1186/cc7896
发表时间：
2009
期刊：
Critical care (London, England)
影响因子：
--
作者：
Hortal J;Muñoz P;Cuerpo G;Litvan H;Rosseel PM;Bouza E;European Study Group on Nosocomial Infections;European Workgroup of Cardiothoracic Intensivists
通讯作者：
European Workgroup of Cardiothoracic Intensivists
影响因子：
6.7
作者：
de la Varga-Martinez, Olga;Gomez-Sanchez, Esther;Heredia-Rodriguez, Maria
通讯作者：
Heredia-Rodriguez, Maria