Establishment and validation of risk prediction model for occult pulmonary infection in elderly patients with type 2 diabetes mellitus accompanied by frailty
Objective To establish a risk prediction model for occult pulmonary infection in elderly patients with type 2 diabetes mellitus(T2DM)accompanied by frailty,and to provide a reference for clinical prevention and con-trol.Methods A retrospective study was conducted on 324 elderly patients with T2DM accompanied by frailty who were hospitalized with pulmonary infection at the First Affiliated Hospital of Zhengzhou University from May 2023 to April 2024.According to the pulmonary infection status,patients were divided into the occult pneumonia group(n=148)and the non-occult pneumonia group(n=176).Clinical data of the two groups were compared.Logistic regression was used to ana-lyze the influencing factors of occult pulmonary infection in elderly T2DM patients accompanied by frailty.A prediction model was constructed.The clinical value of the nomogram model was evaluated by correction curve,receiver operating characteris-tic(ROC)curve,and decision curve(DCA),and external validation was carried out.Results The proportions of patients with age>75 years,dementia,severe weakness,hypothyroidism,long-term bed rest,and coma in the occult pneumonia group were 48.65%,17.57%,52.03%,23.65%,37.84%,and 21.62%,respectively,which were significantly higher than 31.82%,6.25%,34.09%,10.80%,15.34%,and 6.82%in the non-occult pneumonia group(P<0.05).The results of logis-tic regression analysis showed that age,dementia,degree of frailty,hypothyroidism,long-term bed rest,and coma were risk factors for occult pulmonary infection in elderly T2DM inpatients accompanied by frailty(P<0.05).Based on the above six risk factors,the consistency index(C-index)of the nomogram risk prediction model drawn using R language was 0.871.The area under the ROC curve(AUC)was 0.757(95%CI:0.705-0.809).The DCA curve and external valida-tion results showed that the model had good predictive ability and high clinical application value.Conclusion The risk factors for occult pulmonary infection in elderly T2DM inpatients accompanied by frailty are age,dementia,degree of frailty,hypothyroidism,long-term bed rest,and coma.The risk prediction model constructed based on these factors has high discrimination and accuracy,and can effectively screen potential high-risk populations,providing a reference for the clinical management,prevention,and treatment of occult pulmonary infection.
Type 2 diabetes mellitusOccult pulmonary infectionElderlyFrailtyInpatientsRisk prediction modelInternal verificationExternal verification
万方数据
维普
