Development and evaluation of prognosis model of Pneumocystis carinii pneumonia in patients with liver diseases
10.3760/cma.j.cn311365-20241202-00333
- VernacularTitle:肝病合并肺孢子菌肺炎患者预后模型的构建与评价
- Author:
Ling ZHANG
1
;
Caopei ZHENG
;
Xue CHEN
;
Yuqing SUN
;
Ying LIANG
;
Yulin ZHANG
Author Information
1. 首都医科大学附属北京佑安医院呼吸与危重症医学科，北京 100069
- Publication Type:Journal Article
- Keywords:
Nomogram;
Liver diseases;
Pneumocystis carinii pneumonia;
Prognostic model
- From:
Chinese Journal of Infectious Diseases
2025;43(1):24-30
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To analyze the baseline characteristics and prognostic factors of Pneumocystis carinii pneumonia (PCP) in patients with liver diseases (LD), and to develop the nomogram prognosis model. Methods:The patients with liver diseases complicated with PCP (LD-PCP) who admitted to Beijing Youan Hospital, Capital Medical University from January 1st, 2021 to October 31st, 2024 were enrolled in this study. This study was a retrospective case-control study. Data were collected, including baseline characteristics at admission and clinical outcomes. Multivariate logistic regression analysis was employed to identify the independent risk factors of poor prognosis in LD-PCP patients. Subsequently, a nomogram was developed to construct the prognostic model. The performance of this model was evaluated using the receiver operater characteristic (ROC) curve and calibration curve.Results:A total of 61 patients with LD-PCP were enrolled, including 21 in the death group and 40 in the survival group. Multivariate logistic regression analysis revealed that co-infection with Aspergillus and elevated lactate dehydrogenase (LDH) levels were independent risk factors for mortality in patients with LD-PCP (odds ratio ( OR)=12.802, 95% confidence interval ( CI) 1.334 to 122.845, P=0.027; OR=1.009, 95% CI 1.002 to 1.016, P=0.014). The predictive value of prognostic model based on the nomogram was better evidenced by the ROC curve, which yielded an area under the curve (AUC) of 0.835 (95% CI 0.725 to 0.944), with the sensitivity of 71.4% and the specificity of 87.5%. The predictive accuracy of the model was further validated by the calibration curve, and the Brier value was 0.151, the model fitting line had a high degree of agreement with the standard reference line ( P=0.953). Conclusions:Co-infection with Aspergillus and LDH levels are independent risk factors for the poor prognosis of patients with LD-PCP. The prognosis model based on the nomogram has better predictive value and clinical practicality, which could identify high-risk patients in the early stage, and provide theoretical guidance on the patient management.
