Development and validation of a predictive model for respiratory failure with pulmonary infection in elderly patients with COPD
10.3969/j.issn.1006-2483.2025.06.036
- VernacularTitle:老年慢性阻塞性肺疾病患者呼吸衰竭合并肺部感染预测模型的构建与验证
- Author:
Honghua JI
1
;
Wangfei JI
1
Author Information
1. Department of Respiratory Medicine, Nantomg Third People's Hospital, Nantong, Jiangsu 226000,China
- Publication Type:Journal Article
- Keywords:
COPD;
Respiratory failure;
Pulmonary infection;
Model building
- From:
Journal of Public Health and Preventive Medicine
2025;36(6):162-166
- CountryChina
- Language:Chinese
-
Abstract:
Objective To develop a risk prediction model for pulmonary infections in elderly patients with COPD complicated by respiratory failure, and to validate its predictive performance. Methods From January 2022 to September 2023, a cohort of 269 elderly patients with COPD complicated by respiratory failure was selected to serve as the modeling group. Based on the incidence of lung infections, these patients were split into two groups: one with 47 cases of infection and the other with 222 cases of no infection. Clinical data from both groups were compared, and multivariate logistic regression analysis was applied to identify influencing factors and establish a risk prediction model. Additionally, 104 elderly patients with COPD complicated by respiratory failure, recruited between October 2023 and December 2024, were used for external validation of the predictive performance of the model. Results Among the 269 patients, 47 cases developed pulmonary infections, with an incidence rate of 17.47%. A total of 63 pathogenic bacteria strains were detected, with a relatively high proportion being Gram-negative bacteria (73.02%). The duration of hospitalization, IFN-γ, TNF-α, CRP, and PaO2 are factors influencing pulmonary infections in elderly patients with COPD complicated by respiratory failure. For the modeling group, the AUC was 0.975, with a sensitivity of 0.928, a specificity of 0.729, and a maximum Youden index of 0.209. For the validation group, the AUC was 0.958, with a sensitivity of 0.880 and a specificity of 0.522. The H-L test results showed that for the modeling group, χ2=1.1154, and for the validation group, χ2=3.6654, with both P-values being greater than 0.05. Conclusion The duration of hospitalization, IFN-γ, TNF-α, CRP, and PaO2 are factors influencing pulmonary infections in elderly patients with COPD complicated by respiratory failure. The risk prediction model developed based on these factors demonstrates good predictive performance.
