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A risk nomogram for predicting prolonged intensive care unit stays in patients with chronic obstructive pulmonary disease

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机构: [1]School of Nursing, Jinan University, Guangzhou, China. [2]Intensive Care Unit, The First Affiliated Hospital of Jinan University, Guangzhou, China. [3]Department of Neurology, The First Affiliated Hospital of Jinan University, Guangzhou, China. [4]Department of Hematology, Zhongnan Hospital of Wuhan University, Wuhan, China. [5]Department of Clinical Research, The First Affiliated Hospital of Jinan University, Guangzhou, China. [6]Guangdong Provincial Key Laboratory of Traditional Chinese Medicine Informatization, Guangzhou, China.
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关键词: chronic obstructive pulmonary disease intensive care unit length of stay nomograms prolonged intensive care unit stays

摘要:
Providing intensive care is increasingly expensive, and the aim of this study was to construct a risk column line graph (nomograms)for prolonged length of stay (LOS) in the intensive care unit (ICU) for patients with chronic obstructive pulmonary disease (COPD).This study included 4,940 patients, and the data set was randomly divided into training (n = 3,458) and validation (n = 1,482) sets at a 7:3 ratio. First, least absolute shrinkage and selection operator (LASSO) regression analysis was used to optimize variable selection by running a tenfold k-cyclic coordinate descent. Second, a prediction model was constructed using multifactorial logistic regression analysis. Third, the model was validated using receiver operating characteristic (ROC) curves, Hosmer-Lemeshow tests, calibration plots, and decision-curve analysis (DCA), and was further internally validated.This study selected 11 predictors: sepsis, renal replacement therapy, cerebrovascular disease, respiratory failure, ventilator associated pneumonia, norepinephrine, bronchodilators, invasive mechanical ventilation, electrolytes disorders, Glasgow Coma Scale score and body temperature. The models constructed using these 11 predictors indicated good predictive power, with the areas under the ROC curves being 0.826 (95%CI, 0.809-0.842) and 0.827 (95%CI, 0.802-0.853) in the training and validation sets, respectively. The Hosmer-Lemeshow test indicated a strong agreement between the predicted and observed probabilities in the training (χ2 = 8.21, p = 0.413) and validation (χ2 = 0.64, p = 0.999) sets. In addition, decision-curve analysis suggested that the model had good clinical validity.This study has constructed and validated original and dynamic nomograms for prolonged ICU stay in patients with COPD using 11 easily collected parameters. These nomograms can provide useful guidance to medical and nursing practitioners in ICUs and help reduce the disease and economic burdens on patients.Copyright © 2023 Cheng, Li, Wei, Yang, Yuan, Huang, Zhou and Lyu.

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出版当年[2022]版:
大类 | 3 区 医学
小类 | 3 区 医学:内科
最新[2025]版:
大类 | 3 区 医学
小类 | 3 区 医学:内科
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第一作者机构: [1]School of Nursing, Jinan University, Guangzhou, China.
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通讯机构: [5]Department of Clinical Research, The First Affiliated Hospital of Jinan University, Guangzhou, China. [6]Guangdong Provincial Key Laboratory of Traditional Chinese Medicine Informatization, Guangzhou, China.
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