Prediction model and scoring system for in-hospital mortality risk in infants with heart failure aged 1-36 months: A retrospective case-control study.

BACKGROUND

Existing studies report very few factors influencing the mortality of infant and toddler heart failure patients during hospitalization. Due to its high mortality rate, it is an important health issue. Therefore, this study aims to explore the factors influencing infant and toddler heart failure patients during hospitalization, establish predictive models, and a mortality scoring table.

METHODS

The study ultimately included 544 cases of infant heart failure patients. They were randomly divided into a training set (380 cases) and a validation set (164 cases) in a ratio of 7:3. The training set was then further divided into the death group and the survival group for further analysis of indicators during hospitalization.

RESULTS

Using the Lasso regression method, this study selected the best 14 variables from 88 independent variables of infants and toddlers with heart failure. Multivariate Logistic regression results show that TP < 65 g/L (OR = 2.34), pH < 7.35 (OR = 2.79), and Respiratory rate (1-12 months: <30times/min and 13-36 months: <25times/min, OR = 2.34) are independent risk factors. The model evaluation results for the train and test sets of infant and toddler heart failure patients are as follows: C-index values for discrimination in the train and test sets are 0.721 and 0.728, respectively. Fit test calibration evaluations show P values of 0.9958 and 0.9998, both greater than 0.05, indicating good calibration. The AUC values for the train and test sets are 0.75 and 0.64, respectively, showing a good predictive effect of the model. The mortality scoring table divides patients in the train and test sets into low risk, moderate-risk, and high risk categories. Compared to the low risk group, the OR values for the occurrence of mortality in the Medium risk group and high risk group in the train set are 3.78 and 11.67, respectively; in the test set, the OR values for the moderate-risk group and high-risk group are 1.73 and 6.33, respectively.

CONCLUSION

The predictive models and scoring tables established in this study have a good predictive role in assessing the risk of death in infant and toddler heart failure patients aged 1-36 months during hospitalization, providing clinical guidance and reference value.