Construction of Nomogram prediction model for poor prognosis of elderly patients with obstructive sleep apnea hypopnea syndrome and coronary heart disease based on multicenter
Construction of Nomogram prediction model for poor prognosis of elderly patients with obstructive sleep apnea hypopnea syndrome and coronary heart disease based on multicenter
Objective To analyze the influential factors of poor prognosis in elderly patients with obstructive sleep apnea hypopnea syn-drome(OSAHS)complicated with coronary heart disease and establish a Nomogram prediction model based on multi-center analysis.Methods A total of 357 elderly patients with OSAHS complicated with coronary heart disease were selected from Jiangsu Provincial Hospital of Traditional Chinese Medicine from March 2020 to March 2022.The patients were divided into the modeling group(n=250)and the validation group(n=107)according to a ratio of 7∶3.Data of the patients were collected,and the prognosis of the patients was observed during 1-year follow-up,and the modeling group was divided into the good prognosis group(n=215)and the poor prognosis group(n=35)based on patient prognosis.The factors affecting the poor prognosis of elderly patients with OSAHS complicated with coronary heart disease were analyzed by using univariate and multivariate Logistic regression,and Nomogram prediction model was established based on the results.Then the effectiveness of the model was evaluated by using H-L fitting curve,and the differentiation of the model was evaluated by using receiver operating characteristic(ROC)curve.Results The data of patients were collected and univariate analysis showed that Body mass index,sleep apnea hypopnea index(AHI),mean sleep oxygen saturation(SaO2),hypersensitive C-reactive protein(hs-CRP)and interleukin-6(IL-6)were the factors affecting the poor prognosis of elderly patients with OSAHS and coronary heart disease(P＜0.05).Multivariate Logistic regression analysis showed that higher body mass index,higher AHI level,higher hs-CRP level and lower sleep mean SaO2 were the factors affecting the poor prognosis of elderly pa-tients with OSAHS and coronary heart disease(P＜0.05).Validation model showed that the modeling group x2=6.125,P=0.421,area AUC under ROC curve was 0.958(95％CI:0.926-0.980),sensitivity and specificity were 82.86％and 96.28％,respectively.The validation group x2=5.754,P=0.311,AUC was 0.932(95％CI:0.893-0.960),sensitivity and specificity were 85.70％and 88.40％,respective-ly.Conclusion Higher body mass index,higher AHI level,higher hs-CRP level,and lower sleep mean SaO2 are the factors affecting the poor prognosis of elderly patients with OSAHS and coronary heart disease.The Nomogram prediction model established by this method has good differen-tiation and effectiveness,and can help to predict the risk of poor prognosis.It has high clinical value.
维普
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