Construction and Evaluation of Nomogram Prediction Model for Poor Prognosis of Severe Pneumonia Based on miR-221-3p,miR-155-5p and CURB-65 Score
10.13241/j.cnki.pmb.2025.19.017
- VernacularTitle:基于miR-221-3p、miR-155-5p及CURB-65评分对重症肺炎预后不良的Nomogram预测模型构建与评价
- Author:
Ying LI
1
;
Feng NIE
1
;
Yi-jun LIU
1
;
Tao CHEN
1
Author Information
1. 宜春市人民医院重症医学科 江西宜春 336000
- Publication Type:Journal Article
- Keywords:
Severe pneumonia;
miR-221-3p;
miR-155-5p;
CURB-65 score;
Prognosis;
Nomogram prediction model
- From:
Progress in Modern Biomedicine
2025;25(19):3162-3171
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To explore the predictive value of Nomogram prediction model for poor prognosis of severe pneumonia(SP)based on micrornas(miR)-221-3p,miR-155-5p and confusion,uremia,respiratory,BP,age 65years(CURB-65)score.Methods:439 SP patients who were admitted to Yichun People's Hospital from January 2021 to June 2024 were prospectively selected,they were randomly divided into modeling group(n=307)and validation group(n=132)according to the ratio of 7:3.The serum levels of miR-221-3p and miR-155-5p were detected before treatment,and the CURB-65 score was used for evaluation.The prognosis of SP patients within 28 days of hospitalization was observed,and the SP patients were divided into death group and survival group according to the prognosis within 28 days.Lasso regression was used to analyze the influencing factors of poor prognosis of SP patients,and multivariate Logistic regression was used to analyze the risk factors for poor prognosis of SP patients.A Nomogram prediction model for poor prognosis of SP patients was constructed,and the receiver operating characteristic(ROC)curve was used to evaluate the predictive efficacy of the Nomogram model for poor prognosis of SP patients.Results:The mortality rates in the modeling group and the validation group were 29.32%(90/307)and 28.79%(38/132)respectively,and there was no significant difference in mortality rates and clinical data between the two groups(P>0.05).The age,proportion of underlying lung disease,pneumonia severity index(PSI)score,Acute Physiology and Chronic Health Evaluation Ⅱ(APACHE Ⅱ)score,CURB-65 score,serum miR-221-3p,miR-155-5p,C-reactive protein(CRP),interleukin-6(IL-6),tumor necrosis factor-α(TNF-α)and procalcitonin(PCT)indexes in modeling and validation of the death group were higher than those of survival group(P<0.05).Logistic multivariate regression analysis showed that advanced age,high APACHE Ⅱ score,high expression of miR-221-3p,high expression of miR-155-5p and high CURB-65 score were risk factors for poor prognosis of SP(P<0.05).The area under the curve(AUC)of the constructed Nomogram prediction model for the poor prognosis of SP was 0.824,which had good prediction efficiency.Conclusion:High expression of miR-221-3p,high expression of miR-155-5p,high CURB-65 score,older age and high APACHE Ⅱ score are risk factors for poor prognosis of SP patients,and the Nomogram prediction model based on the above factors has a high predictive value for the poor prognosis of SP.