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Development and validation of a nomogram to predict survival in septic patients with heart failure in the intensive care unit.

作者信息

Tong Tong, Guo Yikun, Wang Qingqing, Sun Xiaoning, Sun Ziyi, Yang Yuhan, Zhang Xiaoxiao, Yao Kuiwu

机构信息

Guang'anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, China.

Beijing University of Chinese Medicine, Chao Yang District, Beijing, 100029, China.

出版信息

Sci Rep. 2025 Jan 6;15(1):909. doi: 10.1038/s41598-025-85596-w.


DOI:10.1038/s41598-025-85596-w
PMID:39762511
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11704260/
Abstract

Heart failure is a common complication in patients with sepsis, and individuals who experience both sepsis and heart failure are at a heightened risk for adverse outcomes. This study aims to develop an effective nomogram model to predict the 7-day, 15-day, and 30-day survival probabilities of septic patients with heart failure in the intensive care unit (ICU). This study extracted the pertinent clinical data of septic patients with heart failure from the Critical Medical Information Mart for Intensive Care (MIMIC-IV) database. Patients were then randomly allocated into a training set and a test set at a ratio of 7:3. Cox proportional hazards regression analysis was used to determine independent risk factors influencing patient prognosis and to develop a nomogram model. The model's efficacy and clinical significance were assessed through metrics such as the concordance index (C-index), time-dependent receiver operating characteristic (ROC), calibration curve, and decision curve analysis (DCA). A total of 5,490 septic patients with heart failure were included in the study. A nomogram model was developed to predict short-term survival probabilities, using 13 variables: age, pneumonia, endotracheal intubation, mechanical ventilation, potassium (K), anion gap (AG), lactate (Lac), activated partial thromboplastin time (APTT), white blood cell count (WBC), red cell distribution width (RDW), hemoglobin-to-red cell distribution width ratio (HRR), Sequential Organ Failure Assessment (SOFA) score, and Charlson Comorbidity Index (CCI). The C-index was 0.730 (95% CI 0.719-0.742) for the training set and 0.761 (95% CI 0.745-0.776) for the test set, indicating strong model accuracy, indicating good model accuracy. Evaluations via the ROC curve, calibration curve, and decision curve analyses further confirmed the model's reliability and utility. This study effectively developed a straightforward and efficient nomogram model to predict the 7-day, 15-day, and 30-day survival probabilities of septic patients with heart failure in the ICU. The implementation of treatment strategies that address the risk factors identified in the model can enhance patient outcomes and increase survival rates.

摘要
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/820b/11704260/8876b54b9ed0/41598_2025_85596_Fig6_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/820b/11704260/3010e0d11a3b/41598_2025_85596_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/820b/11704260/3b21e8d6929a/41598_2025_85596_Fig2_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/820b/11704260/9bf21abf86e3/41598_2025_85596_Fig3_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/820b/11704260/f4875a7a2540/41598_2025_85596_Fig4_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/820b/11704260/ec0c1f52f261/41598_2025_85596_Fig5_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/820b/11704260/8876b54b9ed0/41598_2025_85596_Fig6_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/820b/11704260/3010e0d11a3b/41598_2025_85596_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/820b/11704260/3b21e8d6929a/41598_2025_85596_Fig2_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/820b/11704260/9bf21abf86e3/41598_2025_85596_Fig3_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/820b/11704260/f4875a7a2540/41598_2025_85596_Fig4_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/820b/11704260/ec0c1f52f261/41598_2025_85596_Fig5_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/820b/11704260/8876b54b9ed0/41598_2025_85596_Fig6_HTML.jpg

相似文献

[1]
Development and validation of a nomogram to predict survival in septic patients with heart failure in the intensive care unit.

Sci Rep. 2025-1-6

[2]
[Development and validation of a prognostic model for patients with sepsis in intensive care unit].

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[3]
A nomogram for predicting short-term mortality in ICU patients with coexisting chronic obstructive pulmonary disease and congestive heart failure.

Respir Med. 2024

[4]
[Establishment of a nomogram prediction model for 28-day mortality of septic shock patients based on routine laboratory data mining].

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[5]
[Development and validation of a nomogram prediction model for in-hospital mortality risk in patients with sepsis complicated with acute pulmonary embolism].

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[6]
[Development and validation of a nomogram for predicting 3-month mortality risk in patients with sepsis-associated acute kidney injury].

Zhonghua Wei Zhong Bing Ji Jiu Yi Xue. 2024-5

[7]
Association analysis of sepsis progression to sepsis-induced coagulopathy: a study based on the MIMIC-IV database.

BMC Infect Dis. 2025-4-21

[8]
Nomogram predictive model for in-hospital mortality risk in elderly ICU patients with urosepsis.

BMC Infect Dis. 2024-4-26

[9]
[Establishment and validation of a sepsis 28-day mortality prediction model based on the lactate dehydrogenase-to-albumin ratio in patients with sepsis].

Zhonghua Wei Zhong Bing Ji Jiu Yi Xue. 2024-11

[10]
[Constructing a predictive model for the death risk of patients with septic shock based on supervised machine learning algorithms].

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引用本文的文献

[1]
Enhancing prognostic accuracy in sepsis: a modified SOFA score incorporating lymphocyte count as an immune function marker.

Front Cell Infect Microbiol. 2025-7-31

本文引用的文献

[1]
Comprehensive risk factor-based nomogram for predicting one-year mortality in patients with sepsis-associated encephalopathy.

Sci Rep. 2024-10-14

[2]
A nomogram to predict 28-day mortality in patients with sepsis combined coronary artery disease: retrospective study based on the MIMIC-III database.

Front Med (Lausanne). 2024-9-4

[3]
Development and validation of a nomogram to predict risk of septic cardiomyopathy in the intensive care unit.

Sci Rep. 2024-6-19

[4]
The relationship between potassium levels and 28-day mortality in sepsis patients: Secondary data analysis using the MIMIC-IV database.

Heliyon. 2024-5-22

[5]
Uplift modeling to predict individual treatment effects of renal replacement therapy in sepsis-associated acute kidney injury patients.

Sci Rep. 2024-3-10

[6]
The value of five scoring systems in predicting the prognosis of patients with sepsis-associated acute respiratory failure.

Sci Rep. 2024-2-27

[7]
A comparative study of explainable ensemble learning and logistic regression for predicting in-hospital mortality in the emergency department.

Sci Rep. 2024-2-10

[8]
Factors Associated with Postintubation Hypotension Among Patients with Suspected Sepsis in Emergency Department.

Open Access Emerg Med. 2023-11-14

[9]
Mechanisms and management of the coagulopathy of trauma and sepsis: trauma-induced coagulopathy, sepsis-induced coagulopathy, and disseminated intravascular coagulation.

J Thromb Haemost. 2023-12

[10]
A nomogram for predicting sepsis-associated delirium: a retrospective study in MIMIC III.

BMC Med Inform Decis Mak. 2023-9-15

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