Journal of infection and chemotherapy : official journal of the Japan Society of Chemotherapy · 2025
Carbapenem resistant gram negative bacteremia in intensive care unit patients: Development and validation of a nomogram-based 30-day mortality risk prediction model.
СтатьяВалидационное исследованиеНазвание и аннотация: Перевод в очереди
Обработка статьи · этапы, ошибки и управление
Загрузка состояния…
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Türker Nesrin, Korkmaz Ozge Eren, Aydogmus Figen Kaptan, Ayhan Geniş Nur Miray, Müderris Tuba, Aksun Murat
Аннотация
BACKGROUND: Carbapenem-resistant Gram-negative bloodstream infections (CR-GNB BSIs) are increasingly prevalent in intensive care units (ICUs) and associated with high mortality. Accurate early risk stratification tools are lacking.
OBJECTIVES: To develop and internally validate a nomogram-based model predicting 30-day mortality in ICU patients with CR-GNB BSIs.
METHODS: We conducted a retrospective cohort study of adult ICU patients with CR-GNB BSIs at a tertiary hospital in western Turkey (January 2020-October 2024). Demographic, clinical, laboratory, and microbiological data were collected. Patients were randomly split into training (70 %) and validation (30 %) cohorts. Univariable and multivariable logistic regression analyses identified independent mortality predictors, which were incorporated into a nomogram. Model discrimination, calibration, and decision-curve utility were evaluated.
RESULTS: A total of 281 patients were included (median age 66 years; 60.9 % male); 30-day mortality was 58 %. Acinetobacter spp. predominated (51.6 %), followed by Klebsiella spp. (42.3 %) and Pseudomonas spp. (6.1 %). Independent predictors of 30-day mortality included older age, immunosuppression, hypoalbuminemia, elevated white blood cell count, and absence of microbiological cure. The nomogram demonstrated excellent discrimination (AUC 0.895 training; 0.854 validation), good calibration (mean absolute error 0.022-0.059), and meaningful clinical net benefit across intermediate risk thresholds.
CONCLUSIONS: We developed and internally validated a nomogram using routine clinical and laboratory variables to predict 30-day mortality in ICU patients with CR-GNB BSIs. This tool may support early prognostic assessment at bedside and guide individualized management. Prospective multicenter validation is warranted.
OBJECTIVES: To develop and internally validate a nomogram-based model predicting 30-day mortality in ICU patients with CR-GNB BSIs.
METHODS: We conducted a retrospective cohort study of adult ICU patients with CR-GNB BSIs at a tertiary hospital in western Turkey (January 2020-October 2024). Demographic, clinical, laboratory, and microbiological data were collected. Patients were randomly split into training (70 %) and validation (30 %) cohorts. Univariable and multivariable logistic regression analyses identified independent mortality predictors, which were incorporated into a nomogram. Model discrimination, calibration, and decision-curve utility were evaluated.
RESULTS: A total of 281 patients were included (median age 66 years; 60.9 % male); 30-day mortality was 58 %. Acinetobacter spp. predominated (51.6 %), followed by Klebsiella spp. (42.3 %) and Pseudomonas spp. (6.1 %). Independent predictors of 30-day mortality included older age, immunosuppression, hypoalbuminemia, elevated white blood cell count, and absence of microbiological cure. The nomogram demonstrated excellent discrimination (AUC 0.895 training; 0.854 validation), good calibration (mean absolute error 0.022-0.059), and meaningful clinical net benefit across intermediate risk thresholds.
CONCLUSIONS: We developed and internally validated a nomogram using routine clinical and laboratory variables to predict 30-day mortality in ICU patients with CR-GNB BSIs. This tool may support early prognostic assessment at bedside and guide individualized management. Prospective multicenter validation is warranted.