The Journal of international medical research · 2019
A nomogram for predicting the risk of sepsis in patients with acute cholangitis.
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Liu Qingqing, Zhou Quan, Song Meina, Zhao Fanfan, Yang Jin, Feng Xiaojie, Wang Xue, Li Yuanjie, Lyu Jun
Аннотация
OBJECTIVE: Sepsis is a serious complication of acute cholangitis. We aimed to establish a nomogram for predicting the probability of sepsis in patients with acute cholangitis.
METHODS: Subjects were patients with acute cholangitis in the Medical Information Mart for Intensive Care database. Extraneous variables were excluded based on stepwise regression. The nomogram was established using logistic regression.
RESULTS: The predictive model comprised five variables: age (odds ratio [OR]: 1.03, 95% confidence interval [CI]: 1.01–1.04), ventilator-support time (OR: 1.004, 95% CI: 1.001–1.008), diabetes (OR: 10.74, 95% CI: 2.80–70.57), coagulopathy (OR: 2.92, 95% CI: 1.83–4.73) and systolic blood pressure (OR: 0.62, 95% CI: 0.41–0.93). The areas under the receiver operating characteristic curve of the nomogram for the training and validation sets were 0.700 and 0.647, respectively. The Hosmer–Lemeshow goodness-of-fit test revealed high concordance between the predicted and observed probabilities for both the training and validation sets. The calibration plot also demonstrated good agreement between the predicted and observed outcomes for both the training and validation sets.
CONCLUSIONS: We developed and validated a risk-prediction model for sepsis in patients with acute cholangitis. Our results will be helpful for preventing sepsis in patients with acute cholangitis.
METHODS: Subjects were patients with acute cholangitis in the Medical Information Mart for Intensive Care database. Extraneous variables were excluded based on stepwise regression. The nomogram was established using logistic regression.
RESULTS: The predictive model comprised five variables: age (odds ratio [OR]: 1.03, 95% confidence interval [CI]: 1.01–1.04), ventilator-support time (OR: 1.004, 95% CI: 1.001–1.008), diabetes (OR: 10.74, 95% CI: 2.80–70.57), coagulopathy (OR: 2.92, 95% CI: 1.83–4.73) and systolic blood pressure (OR: 0.62, 95% CI: 0.41–0.93). The areas under the receiver operating characteristic curve of the nomogram for the training and validation sets were 0.700 and 0.647, respectively. The Hosmer–Lemeshow goodness-of-fit test revealed high concordance between the predicted and observed probabilities for both the training and validation sets. The calibration plot also demonstrated good agreement between the predicted and observed outcomes for both the training and validation sets.
CONCLUSIONS: We developed and validated a risk-prediction model for sepsis in patients with acute cholangitis. Our results will be helpful for preventing sepsis in patients with acute cholangitis.