Department of Respiratory and Critical Care Medicine, 34753West China Hospital of Sichuan University, Chengdu, China.
Sichuan Cancer Hospital and Institution, Sichuan Cancer Center, Cancer Hospital Affiliate to School of Medicine, UESTC, Chengdu, Sichuan Province, China.
Clin Appl Thromb Hemost. 2022 Jan-Dec;28:10760296221129597. doi: 10.1177/10760296221129597.
We aim to explore the risk factors for in-hospital mortality and to derive a prognostic model for patients with APE in China.
Inpatients with APE were enrolled from West China Hospital between January 2016 and December 2019. Logistic regression analyses were used to explore risk factors for in-hospital mortality and develop a prognostic model.
A total of 813 subjects with APE were included in this study, of whom 542 were in the training set and 271 were in the test set. Multivariable regression analyses indicated that age, male, heart rate, systolic blood pressure, elevated NT-proBNP or troponin T, malignancy, chronic renal insufficiency, and respiratory failure were independent risk factors for in-hospital mortality. For the training set, the area under the curve (AUC) of the ROC curve was 0.899, with a sensitivity and specificity of 89.7% and 77.7%, respectively. The model had higher prediction accuracy than the PESI and sPESI.
The prediction model has proven excellent discrimination and calibration, which may be a useful tool to help physicians make decisions regarding the best treatment strategy.
本研究旨在探讨急性肺栓塞（APE）患者住院期间死亡的危险因素，并建立适合中国人群的预测模型。
回顾性纳入 2016 年 1 月至 2019 年 12 月期间在华西医院住院的 APE 患者。采用 logistic 回归分析探讨住院期间死亡的危险因素，并建立预测模型。
共纳入 813 例 APE 患者，其中 542 例用于训练集，271 例用于测试集。多因素回归分析显示，年龄、男性、心率、收缩压、NT-proBNP 或肌钙蛋白 T 升高、恶性肿瘤、慢性肾功能不全和呼吸衰竭是住院期间死亡的独立危险因素。在训练集中，ROC 曲线下面积（AUC）为 0.899，灵敏度和特异度分别为 89.7%和 77.7%。该模型的预测准确性高于 PESI 和 sPESI。
该预测模型具有良好的区分度和校准度，可能是帮助医生制定最佳治疗策略的有用工具。
