Construction and verification of a prediction nomogram for in-hospital death in elderly CHF patients based on noninvasive hemodynamic parameters
10.3969/j.issn.1009-0126.2024.02.002
- VernacularTitle:基于无创血流动力学参数预测老年慢性心力衰竭患者院内死亡的列线图构建与验证
- Author:
Mingyan YANG
1
;
Wei CHEN
;
Yang GAO
;
Yanan HU
;
Yuan LIU
;
Yufei MA
;
Yan YU
;
Riuhan LIU
;
Jiang YU
;
Jian CAO
Author Information
1. 100853 北京,解放军总医院第二医学中心保健四科国家老年疾病临床医学研究中心
- Keywords:
heart failure;
hemodynamics;
forecasting;
heart disease risk factors;
death;
nomograms
- From:
Chinese Journal of Geriatric Heart Brain and Vessel Diseases
2024;26(2):124-127
- CountryChina
- Language:Chinese
-
Abstract:
Objective To construct a nomogram model for predicting the risk of in-hospital death in CHF patients by using noninvasive hemodynamic monitoring combined with age,DBP,CRP and renal insufficiency(serum creatinine≥ 442 μmol/L).Methods A total of 223 elderly patients with acute onset of CHF admitted in First,Second Medical Centre of Chinese PLA General Hos-pital from September 2022 to March 2023 were recruited in this study.According to their clinical outcomes,they were divided into survival group(196 cases)and death group(27 cases).Based on the in-hospital death and other related indicators,a nomogram model was constructed to predict the risk factors of in-hospital death in CHF.Results Noninvasive hemodynamic mornitoring indi-cated that the death group had significantly higher LVEF and LCWI values but lower LVEDV value than the survival group(P＜0.05,P＜0.01).Multivariate logistic regression analysis showed that age(OR=1.131,95％CI:1.052-1.213,P=0.001),DBP(OR=0.932,95％CI:0.882-0.982,P=0.011),CRP(OR=1.171,95％CI:1.021-1.352,P=0.024),LVEDV(OR=0.984,95％CI:0.962-0.992,P=0.011)and renal insufficiency(OR=5.863,95％CI:1.351-1.731,P=0.004)were independent risk factors for the short-term prognosis of the elderly CHF patients.The AUC value of the nomogram model was 0.902(95％CI:0.819-0.948,P＜0.05),and calibration curve analysis showed the C-index was 0.902,indicating accurate predictive perform-ance.Conclusion Age,DBP,LVEDV,CRP and renal insufficiency are independent risk factors for the short-term prognosis of the elderly CHF patients.
