A nomogram model for short-term mortality risk in elderly patients with sepsis
XIA Yizi1, ZHANG Jing2, LIU Chen2, WENG Jie1, SONG Jiaze3, TIAN Weihua3, XU Hui1.
1.Department of General Practice, the Second Affiliated Hospital of Wenzhou Medical University, Wenzhou 325027, China; 2.Department of Geriatric Medicine, the First Affiliated Hospital of Wenzhou Medical University, Wenzhou 325015, China; 3.The Second Clinical Medical College, Wenzhou Medical University, Wenzhou 325035, China
XIA Yizi,ZHANG Jing,LIU Chen, et al. A nomogram model for short-term mortality risk in elderly patients with sepsis[J]. JOURNAL OF WEZHOU MEDICAL UNIVERSITY, 2023, 53(6): 465-472.
Abstract：Objective: To explore the risk factors affecting the prognosis of death in elderly patients with sepsis, and to construct a nomogram to predict the risk of short-term in-hospital death in elderly patients with sepsis. Methods: The clinical data of elderly sepsis patients from the Second Affiliated Hospital of Wenzhou Medical University and a large multi-center intensive care database in the United States were collected, and the relevant clinical data of patients, such as vital signs, laboratory tests and clinical outcomes, were retrospectively analyzed. Univariate and multivariate Logistic regression analysis was used to screen out risk factors and a nomogram model was constructed to predict death of elderly patients with sepsis within 30 days. Results: The lowest blood oxygen saturation on the first day of admission, the lowest mean arterial pressure, the highest heart rate, the lowest body temperature, the highest respiratory rate, the lowest blood albumin, the highest blood bilirubin, lactate, and brain natriuretic peptide (BNP), mechanical Ventilation, age, liver failure and history of metastatic malignant tumors were independent risk factors for elderly patients with sepsis. The area under the ROC curve (AUC) of nomogram was 0.777 (95%CI=0.743-0.810), and the AUC for predicting the risk of death by external validation was 0.747 (95%CI=0.733-0.762), with both the internal and external calibration curves close to the standard curve. Conclusion: This nomogram has good differentiation and calibration and can accurately predict the death prognosis of elderly patients with sepsis, which provides a basis for clinicians to evaluate the prognosis of elderly patients with sepsis.
