Risk factors and predictive model construction of hospital acute heart failure in elderly patients with chronic heart failure
10.3760/cma.j.cn115682-20220318-01286
- VernacularTitle:老年慢性心力衰竭患者院内发生急性心力衰竭的危险因素分析及预测模型构建
- Author:
Guixiang YU
1
;
Yinghui ZHANG
;
Zhi SHANG
;
Congying LIU
;
Hanxue WANG
;
Sumei TONG
Author Information
1. 北京大学第三医院心血管内科，北京 100191
- Keywords:
Aged;
Chronic heart failure;
In-hospital;
Acute heart failure;
Nomograms;
Prediction model
- From:
Chinese Journal of Modern Nursing
2022;28(33):4639-4645
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To establish a risk prediction model for hospital acute heart failure in elderly patients with chronic heart failure (CHF) .Methods:From January 2018 to December 2020, 619 elderly CHF patients admitted to the Cardiovascular Department of Peking University Third Hospital were selected as the research object by convenience sampling. The patients were divided into the occurrence group ( n=55) and the non-occurrence group ( n=564) according to whether the patients had acute heart failure in hospital. Binomial Logistic regression was used to explore the independent risk factors of acute heart failure in elderly CHF patients. The nomogram model was constructed by R software, and its prediction effect was verified. Results:Binomial Logistic regression showed that high heart rate at admission [ OR=1.021, 95% CI (1.003, 1.039) ], history of cerebrovascular disease [ OR=2.253, 95% CI (1.197, 4.240) ], constipation [ OR=10.382, 95% CI (1.376, 78.308) ], arrhythmia [ OR=2.051, 95% CI (1.079, 3.898) , taking aspirin [ OR=2.741, 95% CI (1.447, 5.193) ], intravenous diuretics [ OR=6.326, 95% CI (2.629, 15.220) ]and high level of N-terminal forebrain natriuretic peptide [ OR=3.511, 95% CI (1.890, 6.521) ]were independent risk factors for hospital onset of acute heart failure in elderly patients with CHF, and the use of vasodilator was a protective factor. The nomogram model was validated. The area under the receiver operating characteristic curve ( AUC) of the subject was 0.808 [95% CI (0.753, 0.864) ], the AUC of internal validation was 0.821 [95% CI (0.764, 0.871) ], and the calibration curve was a straight line with a slope close to 1. Conclusions:There are many risk factors of hospital acute heart failure in elderly CHF patients. The prediction model based on risk factors has good discrimination and calibration, and can predict the risk of acute heart failure in elderly CHF patients in hospital.
