重症监护病房深静脉血栓患者 30 天死亡率的预后列线图。

Prognostic nomogram for 30-day mortality of deep vein thrombosis patients in intensive care unit.

机构信息

Zhongshan School of Medicine, Sun Yat-Sen University, No. 58, Zhongshan Rd.2, Guangzhou, 510080, Guangdong Province, China.

Department of Radiology, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, No. 33, Yingfeng Road, Haizhu District, Guangzhou, 510000, Guangdong Province, China.

出版信息

BMC Cardiovasc Disord. 2021 Jan 6;21(1):11. doi: 10.1186/s12872-020-01823-4.

BACKGROUND

We aimed to use the Medical Information Mart for Intensive Care III database to build a nomogram to identify 30-day mortality risk of deep vein thrombosis (DVT) patients in intensive care unit (ICU).

METHODS

Stepwise logistic regression and logistic regression with least absolute shrinkage and selection operator (LASSO) were used to fit two prediction models. Bootstrap method was used to perform internal validation.

RESULTS

We obtained baseline data of 535 DVT patients, 91 (17%) of whom died within 30 days. The discriminations of two new models were better than traditional scores. Compared with simplified acute physiology score II (SAPSII), the predictive abilities of two new models were improved (Net reclassification improvement [NRI] > 0; Integrated discrimination improvement [IDI] > 0; P < 0.05). The Brier scores of two new models in training set were 0.091 and 0.108. After internal validation, corrected area under the curves for two models were 0.850 and 0.830, while corrected Brier scores were 0.108 and 0.114. The more concise model was chosen to make the nomogram.

CONCLUSIONS

The nomogram developed by logistic regression with LASSO model can provide an accurate prognosis for DVT patients in ICU.

背景

我们旨在利用医疗信息集市重症监护 III 数据库构建一个列线图，以识别重症监护病房（ICU）深静脉血栓形成（DVT）患者的 30 天死亡率风险。

方法

使用逐步逻辑回归和具有最小绝对值收缩和选择算子（LASSO）的逻辑回归来拟合两个预测模型。使用自举法进行内部验证。

结果

我们获得了 535 例 DVT 患者的基线数据，其中 91 例（17%）在 30 天内死亡。两个新模型的判别能力均优于传统评分。与简化急性生理学评分 II（SAPSII）相比，两个新模型的预测能力均得到提高（净重新分类改善[NRI]>0；综合判别改善[IDI]>0；P<0.05）。两个新模型在训练集中的 Brier 评分分别为 0.091 和 0.108。经过内部验证，两个模型的校正曲线下面积分别为 0.850 和 0.830，校正 Brier 评分分别为 0.108 和 0.114。选择更简洁的模型来制作列线图。