Construction and validation of a model for predicting the risk of in-hospital cardiac arrest in emergency rooms
10.3760/cma.j.issn.1671-0282.2024.01.004
- VernacularTitle:院内急诊抢救室心脏骤停风险预测模型构建及验证
- Author:
Yongkai LI
1
;
Zhuanyun LI
;
Xiaojing HE
;
Dandan LI
;
Xin YUAN
;
Xin LI
;
Shuqing JIANG
;
Saimaiti XIALAIBAITIGU
;
Jun XU
;
Jianzhong YANG
Author Information
1. 新疆医科大学第一附属医院急救创伤中心，乌鲁木齐 830000
- Keywords:
Cardiac arrest;
Emergency;
Nomogram;
Predictive model;
LASSO regression
- From:
Chinese Journal of Emergency Medicine
2024;33(1):20-27
- CountryChina
- Language:Chinese
-
Abstract:
Objective:The predictive model of cardiac arrest in the emergency room was constructed and validated based on Logistic regression.Methods:This study was a retrospective cohort study. Patients admitted to the emergency room of the First Affiliated Hospital of Xinjiang Medical University from January 2020 to July 2021 were included. The general information, vital signs, clinical symptoms, and laboratory examination results of the patients were collected, and the outcome was cardiac arrest within 24 hours. The patients were randomly divided into modeling and validation group at a ratio of 7:3. LASSO regression and multivariable logistic regression were used to select predictive factors and construct a prediction model for cardiac arrest in the emergency room. The value of the prediction model was evaluated using the area under the receiver operator characteristic curve (AUC), calibration curve, and decision curve analysis (DCA).Results:A total of 784 emergency room patients were included in the study, 384 patients occurred cardiac arrest. The 10 variables were ultimately selected to construct a risk prediction model for cardiac arrest: Logit( P)= -4.503+2.159×modified early warning score (MEWS score)+2.095×chest pain+1.670×abdominal pain+ 2.021×hematemesis+2.015×cold extremities+5.521×endotracheal intubation+0.388×venous blood lactate-0.100×albumin+0.768×K ++0.001×D-dimer. The AUC of the model group was 0.984 (95% CI: 0.976-0.993) and that of the validation group was 0.972 (95% CI: 0.951-0.993). This prediction model demonstrates good calibration, discrimination, and clinical applicability. Conclusions:Based on the MEWS score, chest pain, abdominal pain, hematemesis, cold extremities, tracheal intubation, venous blood lactate, albumin, K +, and D-dimer, a predictive model for cardiac arrest in the in-hospital emergency room was constructed to predict the probability of cardiac arrest in emergency room patients and adjust the treatment strategy in time.
