Li Qingqing, Zhang Xueqiang, Wu Li, Xu Guiping
Department of Anesthesiology, People's Hospital of Xinjiang Uygur Autonomous Region，Xinjiang Clinical Research Center for Anesthesia Management, Urumqi, 830001, China.
Department of Anesthesiology, Affiliated Cancer Hospital of Xinjiang Medical University, Urumqi, 830000, China.
BMC Infect Dis. 2025 May 30;25(1):776. doi: 10.1186/s12879-025-11161-5.
This study aims to investigate the risk factors affecting short-term mortality in elderly patients with sepsis and a nomogram model was constructed.
A retrospective collection was performed on clinical data of 1116 elderly patients (≥ 65 years) with sepsis hospitalized from January 2014 to December 2023. Patients were divided based on 30-day mortality: death group (392 cases) and survival group (724 cases). Differences in various biochemical indicators were compared, and Cox regression analysis was used to identify independent risk factors. The model's performance was evaluated using receiver operating characteristics (ROC) and Kaplan-Meier curves.
Univariate and multivariate Cox survival analysis were utilized to explore the risk factors for short-term mortality in elderly patients with sepsis. The analysis exhibited a significant association of age, procalcitonin, antiarrhythmic drugs, vasopressors, and albumin with patient survival time. Group differences in vitamin C positivity were observed, but this variable was not included in the prediction model. The nomogram model, demonstrated high diagnostic accuracy (C-index 0.790). Patients were divided into the high-risk group and the low-risk group based on the model's thresholds, showing significantly shorter survival times for the high-risk group.
Increased age, use of antiarrhythmic drugs and vasopressors are independent risk factors for mortality in elderly patients with sepsis, whereas high albumin levels are protective factors. The developed nomogram provides an effective tool for predicting short-term mortality in this patient population.
本研究旨在调查影响老年脓毒症患者短期死亡率的危险因素，并构建列线图模型。
回顾性收集2014年1月至2023年12月住院的1116例老年（≥65岁）脓毒症患者的临床资料。根据30天死亡率将患者分为死亡组（392例）和存活组（724例）。比较各项生化指标的差异，并采用Cox回归分析确定独立危险因素。使用受试者工作特征曲线（ROC）和Kaplan-Meier曲线评估模型性能。
采用单因素和多因素Cox生存分析探讨老年脓毒症患者短期死亡的危险因素。分析显示年龄、降钙素原、抗心律失常药物、血管升压药和白蛋白与患者生存时间显著相关。观察到维生素C阳性的组间差异，但该变量未纳入预测模型。列线图模型显示出较高的诊断准确性（C指数为0.790）。根据模型阈值将患者分为高风险组和低风险组，高风险组的生存时间明显较短。
年龄增加、使用抗心律失常药物和血管升压药是老年脓毒症患者死亡的独立危险因素，而高白蛋白水平是保护因素。所构建的列线图为预测该患者群体的短期死亡率提供了一种有效工具。
