Xu Jinxin, Zhang Wenshan, Cai Yingjie, Lin Jingping, Yan Chun, Bai Meirong, Cao Yunpeng, Ke Sunkui, Liu Yali
Department of Thoracic Surgery, Zhongshan Hospital Xiamen University, Xiamen, China.
Department of Thoracic Surgery, Zhangzhou Affiliated Hospital of Fujian Medical University, Zhangzhou, China.
Heliyon. 2023 Sep 14;9(9):e20137. doi: 10.1016/j.heliyon.2023.e20137. eCollection 2023 Sep.
The study aim to construct an effective model for predicting the survival period of COVID-19 patients.
Clinical data of 386 COVID-19 patients were collected from December 2022 to January 2023. The patients were randomly divided into training and validation cohorts in a 7:3 ratio. LASSO regression and multivariate Cox regression analyses were used to identify prognostic factors, and a nomogram was constructed. Nomogram was evaluated using decision curve analysis, receiver operating characteristic curve, consistency index (c-index), and calibration curve.
86 patients (22.3%) died. A new nomogram for predicting the survival was established based on age, resting oxygen saturation, Blood urea nitrogen (BUN), c-reactive protein-to-albumin ratio (CAR), and pneumonia visual score. The decision curve indicated high clinical applicability. The nomogram c-indexes in the training and validation cohorts were 0.846 and 0.81, respectively. The area under the curves (AUCs) for the 15-day and 30-day survival probabilities were 0.906 and 0.869 in the training cohort, and 0.851 and 0.843 in the validation cohort. The calibration curves demonstrated consistency between predicted and actual survival probabilities.
Our nomogram has the capacity to assist clinical practitioners in estimating the survival rate of COVID-19 patients, thereby facilitating more optimal management strategies and therapeutic interventions with substantial clinical applicability.
本研究旨在构建一个预测新型冠状病毒肺炎(COVID-19)患者生存期的有效模型。
收集2022年12月至2023年1月期间386例COVID-19患者的临床数据。患者按7:3的比例随机分为训练组和验证组。采用LASSO回归和多因素Cox回归分析确定预后因素,并构建列线图。使用决策曲线分析、受试者工作特征曲线、一致性指数(c指数)和校准曲线对列线图进行评估。
86例患者(22.3%)死亡。基于年龄、静息血氧饱和度、血尿素氮(BUN)、C反应蛋白与白蛋白比值(CAR)和肺炎视觉评分建立了一个预测生存的新列线图。决策曲线表明其具有较高的临床适用性。训练组和验证组列线图的c指数分别为0.846和0.81。训练组中15天和30天生存概率的曲线下面积(AUC)分别为0.906和0.869,验证组中分别为0.851和0.843。校准曲线显示预测生存概率与实际生存概率之间具有一致性。
我们的列线图能够帮助临床医生估计COVID-19患者的生存率,从而促进更优化的管理策略和治疗干预,具有较高的临床适用性。