Huang Sisi, Chen Limin, Liu Jiao, Zhang Sheng, Zhang Lidi, Wen Zhenliang, Chen Yizhu, Chen Dechang
Department of Critical Care Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
Department of Critical Care Medicine, Ruijin Hospital North, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
Front Med (Lausanne). 2021 Feb 22;8:627416. doi: 10.3389/fmed.2021.627416. eCollection 2021.
Complicated intra-abdominal infections (cIAIs) in the abdominal cavity or within an abdominal organ are numerous and frequent dangerous entities in the treatment of critically ill patients. Early clinical evaluation is necessary. This retrospective multicenter study included patients from 10 intensive care units (ICUs). Risk factors for the overall survival (OS) of patients with cIAI were selected using least absolute shrinkage and selection operator regression, and a nomogram was constructed subsequently. Calibration curve and receiver operating characteristic (ROC) curve were used to evaluate the calibration and discriminative ability. In total, 544 patients diagnosed with cIAI were enrolled and divided into the study ( = 276) and validation ( = 268) sets. Sex, acute gastrointestinal injury, acute kidney injury, rare bacterium infection, Charlson score, and APACHE II score were identified as independent risk factors and were constructed for the nomogram. The nomogram showed marked calibration capability with a concordance index (C-index) of 0.909 and 0.831 in the study and validation set, respectively. Compared with the common clinical prognostic scoring system, the nomogram achieved the highest discrimination ability with an area under the curve (AUC) value of 0.91 and 0.83 in the study set and validation set, respectively. Our newly constructed nomogram provides a useful tool for risk stratification and prognosis evaluation of cIAI.
腹腔内或腹部器官内的复杂性腹腔内感染(cIAIs)在危重症患者的治疗中是众多且常见的危险情况。早期临床评估很有必要。这项回顾性多中心研究纳入了来自10个重症监护病房(ICU)的患者。使用最小绝对收缩和选择算子回归选择cIAI患者总体生存(OS)的危险因素,随后构建列线图。采用校准曲线和受试者工作特征(ROC)曲线评估校准和判别能力。总共纳入了544例诊断为cIAI的患者,并分为研究组(n = 276)和验证组(n = 268)。性别、急性胃肠损伤、急性肾损伤、罕见细菌感染、Charlson评分和APACHE II评分被确定为独立危险因素,并用于构建列线图。该列线图在研究组和验证组中的校准能力显著,一致性指数(C指数)分别为0.909和0.831。与常见的临床预后评分系统相比,该列线图在研究组和验证组中的判别能力最高,曲线下面积(AUC)值分别为0.91和0.83。我们新构建的列线图为cIAI的风险分层和预后评估提供了一个有用的工具。