1.Construction and verification of a prediction nomogram for in-hospital death in elderly CHF patients based on noninvasive hemodynamic parameters
Mingyan YANG ; Wei CHEN ; Yang GAO ; Yanan HU ; Yuan LIU ; Yufei MA ; Yan YU ; Riuhan LIU ; Jiang YU ; Jian CAO
Chinese Journal of Geriatric Heart Brain and Vessel Diseases 2024;26(2):124-127
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.