Development and external validation of a nomogram for predicting postoperative pneumonia in aneurysmal subarachnoid hemorrhage

doi:10.3389/fneur.2023.1251570

科研成果详情

题名	Development and external validation of a nomogram for predicting postoperative pneumonia in aneurysmal subarachnoid hemorrhage
作者	Jin, Xiao1; Wang, Shijia1; Zhang, Chengwei2; Yang, Song1; Lou, Lejing1; Xu, Shuyao1; Cai, Chang1
发表日期	2023-09-04
发表期刊	FRONTIERS IN NEUROLOGY 影响因子和分区
语种	英语
原始文献类型	Article
关键词	postoperative pneumonia aneurysmal subarachnoid hemorrhage Medical Information Mart for Intensive Care nomogram external validation
其他关键词	DELAYED CEREBRAL-ISCHEMIA ; ASSOCIATION ; PLATELET ; ALBUMIN ; BURDEN ; RISK
摘要	BackgroundPostoperative pneumonia (POP) is a common complication after aneurysmal subarachnoid hemorrhage (aSAH) associated with increased mortality rates, prolonged hospitalization, and high medical costs. It is currently understood that identifying pneumonia early and implementing aggressive treatment can significantly improve patients' outcomes. The primary objective of this study was to explore risk factors and develop a logistic regression model that assesses the risks of POP.MethodsAn internal cohort of 613 inpatients with aSAH who underwent surgery at the Neurosurgical Department of First Affiliated Hospital of Wenzhou Medical University was retrospectively analyzed to develop a nomogram for predicting POP. We assessed the discriminative power, accuracy, and clinical validity of the predictions by using the area under the receiver operating characteristic curve (AUC), the calibration curve, and decision curve analysis (DCA). The final model was validated using an external validation set of 97 samples from the Medical Information Mart for Intensive Care IV (MIMIC-IV) database.ResultsAmong patients in our internal cohort, 15.66% (n = 96/613) of patients had POP. The least absolute shrinkage and selection operator (LASSO) regression analysis identified the Glasgow Coma Scale (GCS), mechanical ventilation time (MVT), albumin, C-reactive protein (CRP), smoking, and delayed cerebral ischemia (DCI) as potential predictors of POP. We then used multivariable logistic regression analysis to evaluate the effects of these predictors and create a final model. Eighty percentage of patients in the internal cohort were randomly assigned to the training set for model development, while the remaining 20% of patients were allocated to the internal validation set. The AUC values for the training, internal, and external validation sets were 0.914, 0.856, and 0.851, and the corresponding Brier scores were 0.084, 0.098, and 0.143, respectively.ConclusionWe found that GCS, MVT, albumin, CRP, smoking, and DCI are independent predictors for the development of POP in patients with aSAH. Overall, our nomogram represents a reliable and convenient approach to predict POP in the patient population.
资助项目	General Program (Key Program, Major Research Plan) of the National Natural Science Foundation of China [81470225]; Basic Science Foundation of Wenzhou City [Y2020003]
出版者	FRONTIERS MEDIA SA
ISSN	1664-2295
卷号	14
DOI	10.3389/fneur.2023.1251570
页数	12
WOS类目	Clinical Neurology ; Neurosciences
WOS研究方向	Neurosciences & Neurology
WOS记录号	WOS:001066902000001
收录类别	SCIE ; PUBMED ; SCOPUS
URL	查看原文
PubMed ID	37745673
SCOPUSEID	2-s2.0-85171452055
通讯作者地址	[Cai, Chang]Department of Respiratory and Critical Care Medicine,The First Affiliated Hospital of Wenzhou Medical University,Wenzhou,China
Scopus学科分类	Neurology;Neurology (clinical)
引用统计
文献类型	期刊论文
条目标识符	https://kms.wmu.edu.cn/handle/3ETUA0LF/183191
专题	附属第一医院
通讯作者	Cai, Chang
作者单位	1.Department of Respiratory and Critical Care Medicine,The First Affiliated Hospital of Wenzhou Medical University,Wenzhou,China; 2.Department of Neurosurgery,The First Affiliated Hospital of Wenzhou Medical University,Wenzhou,China
第一作者单位	附属第一医院
通讯作者单位	附属第一医院
第一作者的第一单位	附属第一医院
推荐引用方式 GB/T 7714	Jin, Xiao,Wang, Shijia,Zhang, Chengwei,et al. Development and external validation of a nomogram for predicting postoperative pneumonia in aneurysmal subarachnoid hemorrhage[J]. FRONTIERS IN NEUROLOGY,2023,14.
APA	Jin, Xiao., Wang, Shijia., Zhang, Chengwei., Yang, Song., Lou, Lejing., ... & Cai, Chang. (2023). Development and external validation of a nomogram for predicting postoperative pneumonia in aneurysmal subarachnoid hemorrhage. FRONTIERS IN NEUROLOGY, 14.
MLA	Jin, Xiao,et al."Development and external validation of a nomogram for predicting postoperative pneumonia in aneurysmal subarachnoid hemorrhage".FRONTIERS IN NEUROLOGY 14(2023).