Zhang Zheng, Liu Yahui, Cheng Qianqian, Zhang Jing, Gao Chuanyu
Department of Cardiology, Zhengzhou University People's Hospital, Henan Provincial People's Hospital, No. 7 Weiwu Road, Zhengzhou, 450003, Henan, China.
Henan Provincial Key Lab for Control of Coronary Heart Disease, Zhengzhou University Fuwai Central China Cardiovascular Hospital, Zhengzhou, China.
Sci Rep. 2024 Jul 31;14(1):17690. doi: 10.1038/s41598-024-68792-y.
Ventricular septal rupture (VSR) is a mechanical complication of acute myocardial infarction (AMI), and its mortality has not decreased significantly in recent decades. However, no clinical model has been developed to predict short-term mortality in patients with post-infarction VSR (PIVSR). This study aimed to develop a nomogram to predict the 30-day mortality by using the clinical characteristics of hospitalized patients with PIVSR. The least absolute shrinkage and selection operator (LASSO) and multivariate logistic regression analysis was used to construct a nomogram by R. The model was evaluated by the area under the curve (AUC), calibration curve and decision curve analysis (DCA). The bootstrap method was used to validate the model internally. As a result, a nomogram was constructed by using six variables, including CRRT, mechanical ventilation, PPCI, WBC, PASP and methods of treatment. The AUC of the prediction model was 0.96 (0.93, 0.98). The prediction model was well calibrated. The DCA showed that if the threshold probability was between 15% and 95%, the nomogram model would provide a net benefit. The well-constructed and evaluated nomogram can be beneficial to clinicians to predict the risk of death within 30 days in patients with PIVSR.
室间隔破裂（VSR）是急性心肌梗死（AMI）的一种机械并发症，近几十年来其死亡率并未显著下降。然而，尚未开发出临床模型来预测心肌梗死后室间隔破裂（PIVSR）患者的短期死亡率。本研究旨在通过利用住院PIVSR患者的临床特征开发一种列线图，以预测30天死亡率。使用最小绝对收缩和选择算子（LASSO）和多变量逻辑回归分析，通过R构建列线图。通过曲线下面积（AUC）、校准曲线和决策曲线分析（DCA）对模型进行评估。采用自助法对模型进行内部验证。结果，利用包括连续性肾脏替代治疗（CRRT）、机械通气、急诊经皮冠状动脉介入治疗（PPCI）、白细胞（WBC）、肺动脉收缩压（PASP）和治疗方法在内的六个变量构建了列线图。预测模型的AUC为0.96（0.93，0.98）。预测模型校准良好。DCA显示，如果阈值概率在15%至95%之间，列线图模型将提供净效益。构建良好且经过评估的列线图有助于临床医生预测PIVSR患者30天内的死亡风险。
