Shen Qian
Department of Pharmacy, Lianyungang First People's Hospital Gunnan Campus, Lianyungang, China.
Clin Endocrinol (Oxf). 2025 Sep 14. doi: 10.1111/cen.70033.
This study aimed to develop and validate a clinical feature-based nomogram to predict the risk of lung infection in diabetic patients.
A total of 168 patients diagnosed with pulmonary infections at our hospital-comprising both diabetic and Nondiabetic individuals-were retrospectively enrolled and divided into a training cohort and an internal validation cohort. Feature selection was performed using the least absolute shrinkage and selection operator (LASSO) method, followed by multivariate logistic regression analysis to construct the predictive nomogram. Model performance was evaluated through calibration curves, receiver operating characteristic (ROC) analysis, and decision curve analysis (DCA) to assess predictive accuracy, calibration, and clinical utility, respectively.
Multivariate analysis identified advanced age, male sex, abnormal neutrophil count, elevated glycated hemoglobin (HbA1c), and fasting plasma glucose (FPG) levels as independent risk factors for diabetic lung infection. A nomogram incorporating these variables and other clinically relevant predictors was constructed. The area under the ROC curve (AUC) was 0.919 (95%CI: 0.825-0.937) in the training set and 0.862 (95% CI: 0.819-0.912) in the validation set, indicating strong discriminative ability. Calibration curves demonstrated good agreement between predicted and observed outcomes. DCA confirmed the nomogram's clinical value across a wide range of threshold probabilities.
We developed a robust and clinically applicable nomogram for predicting the risk of pneumonia in diabetic patients with pulmonary infections. This model exhibits high accuracy and may assist clinicians in identifying high-risk individuals who could benefit from early preventive measures and timely interventions.
本研究旨在开发并验证一种基于临床特征的列线图,以预测糖尿病患者肺部感染的风险。
回顾性纳入我院诊断为肺部感染的168例患者,包括糖尿病患者和非糖尿病患者,并将其分为训练队列和内部验证队列。采用最小绝对收缩和选择算子(LASSO)方法进行特征选择,随后进行多因素逻辑回归分析以构建预测列线图。通过校准曲线、受试者工作特征(ROC)分析和决策曲线分析(DCA)分别评估模型性能,以评估预测准确性、校准和临床实用性。
多因素分析确定高龄、男性、中性粒细胞计数异常、糖化血红蛋白(HbA1c)升高和空腹血糖(FPG)水平是糖尿病肺部感染的独立危险因素。构建了一个纳入这些变量和其他临床相关预测因素的列线图。训练集的ROC曲线下面积(AUC)为0.919(95%CI:0.825-0.937),验证集为0.862(95%CI:0.819-0.912),表明具有较强的判别能力。校准曲线显示预测结果与观察结果之间具有良好的一致性。DCA证实了列线图在广泛的阈值概率范围内的临床价值。
我们开发了一种强大且临床适用的列线图,用于预测糖尿病肺部感染患者发生肺炎的风险。该模型具有较高的准确性,可协助临床医生识别可能从早期预防措施和及时干预中获益的高危个体。