摘要
目的建立并验证脓毒症并发急性肺损伤(ALI)风险的列线图模型。方法选取257例脓毒症患者为建模组,另以7∶3的比例收集同期110例脓毒症患者为验证组。两组均根据是否并发ALI分为ALI组与无ALI组。Logistic回归分析脓毒症患者并发ALI的影响因素,R软件构建脓毒症并发ALI风险的列线图模型并进行验证。结果建模组ALI发生率为33.85%,验证组ALI发生率为31.82%。肺部感染(OR=16.505)、降钙素原(PCT,OR=2.640)、肿瘤坏死因子-α(TNF-α,OR=1.098)、氧合指数(OR=0.867)、APACHEⅡ评分(OR=1.750)是脓毒症并发ALI的影响因素(P<0.05)。基于以上5个指标构建列线图预测模型,建模组和验证组列线图预测ALI发生风险的AUC分别为0.858、0.877,H-L检验显示一致性较好,校准曲线预测概率与实际概率接近,提示模型预测ALI发生风险具有良好准确度。结论脓毒症并发ALI影响因素包括APACHEⅡ评分、肺部感染、PCT、TNF-α、氧合指数,据此构建ALI发生风险的列线图模型预测价值较好,可为个体化预防脓毒症患者并发ALI提供参考。
Aim To establish and validate an column chart model for the risk of sepsis complicated with acute lung injury(ALI)in sepsis.Methods A total of 257 patients with sepsis were selected as the modeling group,and 110 patients with sepsis during the same period were collected as the validation group in a 7∶3 ratio.The two groups were divided into an ALI group and a non-ALI group according to whether they had concurrent ALI.Logistic regression model was applied to analyze the influencing factors of ALI in sepsis patients,R software was applied to construct a column chart model for the risk of sepsis complicated with ALI,and validation was conducted.Results The incidence rate in the modeling group was 33.85%,while the incidence rate in the validation group was 31.82%.The pulmonary infection(OR=16.505),procalcitonin(PCT,OR=2.640),tumor necrosis factor-α(TNF-α,OR=1.098),oxygenation index(OR=0.867),and APACHEⅡscore(OR=1.750)were the influencing factors of sepsis complicated with ALI(P<0.05).Based on the above 5 indicators,a column chart prediction model was constructed.The AUC of the column charts for predicting the risk of ALI occurrence in the modeling group and validation group were 0.858 and 0.877,respectively.The H-L test showed good consistency,and the predicted probability of the calibration curve was close to the actual probability,indicating that the model has good accuracy in predicting the risk of ALI occurrence.Conclusion The influencing factors of sepsis complicated with ALI include APACHEⅡscore,pulmonary infection,PCT,TNF-α,and oxygenation index.Based on this,the constructed column chart model for predicting the risk of ALI has good predictive value and can provide reference for individualized prevention of ALI in sepsis patients.
作者
余校宇
龙江超
黄明海
YU Xiaoyu;LONG Jiangchao;HUANG Minghai(Sichuan Provincial People's Hospital(Medical Group)Dongli Hospital,Chengdu 601000,Sichuan,China;Dafang People's Hospital,Bijie 551669,Guizhou,China)
出处
《中南医学科学杂志》
CAS
2024年第4期559-562,共4页
Medical Science Journal of Central South China
基金
四川省科技计划项目(2019YFQ0003)。
关键词
脓毒症
急性肺损伤
列线图模型
影响因素
sepsis
acute lung injury
column chart model
influence factor
