Wei Meng, Shang Shuai, Lv Huasheng, Liang Xiaoyan, Lu Yanmei, Tang Baopeng
Department of Cardiac Function, The First Affiliated Hospital of Xinjiang Medical University, Urumqi, 830000, Xinjiang, China.
Xinjiang Key Laboratory of Cardiac Electrophysiology and Cardiac Remodeling, The First Affiliated Hospital of Xinjiang Medical University, Urumqi, 830000, Xinjiang, China.
Heliyon. 2025 Jan 18;11(3):e42110. doi: 10.1016/j.heliyon.2025.e42110. eCollection 2025 Feb 15.
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.
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.
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.
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.
现有研究报告显示，影响婴幼儿心力衰竭患者住院期间死亡率的因素非常少。由于其高死亡率，这是一个重要的健康问题。因此，本研究旨在探讨影响婴幼儿心力衰竭患者住院期间的因素，建立预测模型和死亡率评分表。
本研究最终纳入544例婴幼儿心力衰竭患者。他们以7:3的比例随机分为训练集（380例）和验证集（164例）。然后将训练集进一步分为死亡组和生存组，以进一步分析住院期间的指标。
本研究采用Lasso回归方法，从88个婴幼儿心力衰竭独立变量中筛选出最佳的14个变量。多因素Logistic回归结果显示，TP<65g/L（OR=2.34）、pH<7.35（OR=2.79）以及呼吸频率（1 - 12个月：<30次/分钟，13 - 36个月：<25次/分钟，OR=2.34）是独立危险因素。婴幼儿心力衰竭患者训练集和测试集的模型评估结果如下：训练集和测试集的鉴别C指数值分别为0.721和0.728。拟合检验校准评估显示P值分别为0.9958和0.9998，均大于0.05，表明校准良好。训练集和测试集的AUC值分别为0.75和0.64，表明模型具有良好的预测效果。死亡率评分表将训练集和测试集的患者分为低风险、中度风险和高风险类别。与低风险组相比，训练集中度风险组和高风险组死亡发生的OR值分别为3.78和11.67；在测试集中，中度风险组和高风险组的OR值分别为1.73和6.33。
本研究建立的预测模型和评分表在评估1 - 36个月婴幼儿心力衰竭患者住院期间死亡风险方面具有良好的预测作用，提供了临床指导和参考价值。
