Department of Nursing, School of Health and Nursing, Wuxi Taihu University, 68 Qian Rong Rode, Bin Hu District, Wuxi, China.
Cardiac Catheter Room, Wuxi People's Hospital, Jiangsu, No.299 Qing Yang Road, Wuxi, 214000, China.
Sci Rep. 2024 Aug 19;14(1):19148. doi: 10.1038/s41598-024-69581-3.
This study aimed to develop and validate a predictive model of all-cause mortality risk in American adults aged ≥ 18 years with diabetes. 7918 participants with diabetes were enrolled from the National Health and Nutrition Examination Survey (NHANES) 1999-2016 and followed for a median of 96 months. The primary study endpoint was the all-cause mortality. Predictors of all-cause mortality included age, Monocytes, Erythrocyte, creatinine, Nutrition Risk Index (NRI), neutrophils/lymphocytes (NLR), smoking habits, alcohol consumption, cardiovascular disease (CVD), urinary albumin excretion rate (UAE), and insulin use. The c-index was 0.790 (95% CI 0.779-0.801, P < 0.001) and 0.792 (95% CI: 0.776-0.808, P < 0.001) for the training and validation sets, respectively. The area under the ROC curve was 0.815, 0.814, 0.827 and 0.812, 0.818 and 0.829 for the training and validation sets at 3, 5, and 10 years of follow-up, respectively. Both calibration plots and DCA curves performed well. The model provides accurate predictions of the risk of death for American persons with diabetes and its scores can effectively determine the risk of death in outpatients, providing guidance for clinical decision-making and predicting prognosis for patients.
本研究旨在为年龄≥18 岁的美国成年糖尿病患者建立并验证一个全因死亡率风险预测模型。从 1999 年至 2016 年的全国健康和营养检查调查（NHANES）中纳入了 7918 名糖尿病患者，并对其进行了中位数为 96 个月的随访。主要研究终点为全因死亡率。全因死亡率的预测因子包括年龄、单核细胞、红细胞、肌酐、营养风险指数（NRI）、中性粒细胞/淋巴细胞比值（NLR）、吸烟习惯、饮酒、心血管疾病（CVD）、尿白蛋白排泄率（UAE）和胰岛素使用情况。训练集和验证集的 c 指数分别为 0.790（95%CI：0.779-0.801，P<0.001）和 0.792（95%CI：0.776-0.808，P<0.001）。训练集和验证集的 ROC 曲线下面积分别为 0.815、0.814、0.827 和 0.812、0.818 和 0.829，在随访 3、5 和 10 年时。校准图和 DCA 曲线均表现良好。该模型能准确预测美国糖尿病患者的死亡风险，其评分可有效确定门诊患者的死亡风险，为临床决策提供指导并预测患者预后。
