Establishment of the early risk model for acute respiratory distress syndrome caused by viral pneumonia
Objective To explore the risk factors of acute respiratory distress syndrome(ARDS)in patients with viral pneumonia,and to establish an early risk prediction model.Methods A total of 400 patients with viral pneumo-nia admitted to the ICU of our hospital from April 2019 to April 2023 were selected for retrospective analysis,and were divided into the training set(n=280)and the verification set(n=120)according to the ratio of 7∶3.The pa-tients in the training set were grouped according to the presence or absence of ARDS,and divided into the ARDS group(n=97)and the non-ARDS group(n=183).The clinical data of 2 groups were compared,univariate binary logistic regression analysis multivarinte analyzsis were used to analyze the related risk factors,and the prediction effect of the model was tested by ROC curve and calibration curve,and the data of the validation set were used to draw 2 kinds of curves to externally verify the predictive efficacy of the model.Results The results of the multivariate analysis showed that patient age between 2 groups(OR=1.057,95％CI was from 1.021 to 1.094,P＜0.002),combined with diabetes mellitus(OR=3.712,95％CI was from 1.693 to 8.141,P=0.001),lung injury predic-tion score(OR=1.375,95％CI was from 1.121 to 1.686,P=0.002),UK National Early Warning Score(OR=1.134,95％CI was from 1.045 to 1.230,P=0.003),and pneumonia severity index(OR=1.029,95％CI was from 1.015 to 1.043,P＜0.001)were the independent risk factors for ARDS due to viral pneumonia(P＜0.05),Based on this basis,the risk prediction model was established.Model formula Z=0.055 Age+1.312 combined di-abetes+0.318 lung injury prediction score+0.126 UK National Early Warning Score+0.028 pneumonia severi-ty index-16.430.The area under the ROC curve was 0.878(95％CI was from 0.838 to 0.919,P＜0.001),with a sensitivity of 0.856,specificity of 0.803,and Youden index of 0.659.Conclusion This model can effectively predict the occurrence of ARDS in patients with viral pneumonia,and provide a reference for medical staff to formulate nurs-ing plans for early prevention of ARDS in patients with viral pneumonia.It has good early warning value.
万方数据
维普
