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基于化脓性肝脓肿患者的列线图预测脓毒症的开发与验证。

Development and validation of a nomogram for predicting sepsis in patients with pyogenic liver abscess.

机构信息

Department of Gastroenterology and Hepatology, The First Affiliated Hospital of Xiamen University, School of Medicine, Xiamen University, Xiamen, 361003, China.

Department of Gastroenterology, The Third Hospital of Xiamen, Xiamen, China.

出版信息

Sci Rep. 2023 Jul 5;13(1):10849. doi: 10.1038/s41598-023-37907-2.

Abstract

Pyogenic liver abscess (PLA) is a severe condition that significantly increases the risk of sepsis. However, there is a notable dearth of research regarding the prediction of sepsis in PLA patients. The objective of this study was to develop and validate a prognostic nomogram for predicting sepsis in PLA patients. A total of 206 PLA patients were enrolled in our study, out of which 60 individuals (29.1%) met the Sepsis-3 criteria. Independent risk factors for sepsis were identified through univariate and multivariate logistic regression analyses. Subsequently, a nomogram was developed based on age, positive blood culture, procalcitonin, alanine aminotransferase, blood urea nitrogen, and D-dimer. The nomogram demonstrated excellent calibration and discrimination, as evidenced by the area under the receiver operating characteristic curve (AUC) values of 0.946 (95% confidence interval [CI], 0.912-0.979) and 0.980 (95%CI 0.951-1.000) in the derivation and validation cohorts, respectively. Furthermore, decision-curve analysis confirmed the clinical utility of the nomogram. This study provides valuable insights for the prevention of sepsis in PLA patients and underscores the potential application of the prognostic nomogram in clinical practice.

摘要

化脓性肝脓肿(PLA)是一种严重的病症,会显著增加脓毒症的风险。然而,目前关于 PLA 患者脓毒症预测的研究还相当匮乏。本研究旨在开发和验证一种预测 PLA 患者脓毒症的预后列线图。我们的研究共纳入了 206 名 PLA 患者,其中 60 名(29.1%)符合 Sepsis-3 标准。通过单因素和多因素逻辑回归分析确定了脓毒症的独立危险因素。随后,基于年龄、阳性血培养、降钙素原、丙氨酸氨基转移酶、血尿素氮和 D-二聚体,建立了一个列线图。该列线图在验证队列中表现出了极好的校准和区分能力,其受试者工作特征曲线下面积(AUC)值分别为 0.946(95%置信区间 [CI],0.912-0.979)和 0.980(95%CI,0.951-1.000)。此外,决策曲线分析证实了该列线图的临床实用性。本研究为 PLA 患者脓毒症的预防提供了有价值的见解,并强调了该预后列线图在临床实践中的潜在应用。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/48be/10322897/fa03cdb1d9fb/41598_2023_37907_Fig1_HTML.jpg

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