Risk prediction model of in-hospital renal function deterioration in patients with acute heart failure with decreased ejection fraction
Objective To explore the factors influencing renal function deterioration(WRF)in patients with acute heart fail-ure with decreased ejection fraction(AHFrEF),and to construct a risk prediction model.Methods A total of 418 patients with AH-FrEF admitted to General Hospital of PLA Xinjiang Military Region from January 2020 to December 2023 were selected and divided into WRF group(98 cases)and non-WRF group(320 cases)according to whether hospital-acquired WRF occurred within 7 days of hospi-talization.logistic regression was used to analyze the influencing factors of hospital-acquired WRF in AHFrEF patients,and a risk pre-diction model was established.Results Logistic regression analysis showed that age,diabetes,moist rales≥1/3 lung field,edema of lower limbs,jugular vein filling>10 cm,creatinine,lactic acid,N-terminal pro-brain natriuretic peptide(NT-proBNP),troponin T and chloride ion levels were the risk factors of hospital-acquired WRF in AHFrEF patients,and hemoglobin was the protective factor(P<0.05).Bootstrap internal verification results show that the consistency index(C-index)was 0.864.The area under ROC curve was 0.853,95%CI(0.812-0.947),the sensitivity was 87.25%,and the specificity was 78.34%.Hosmer-Lemeshow goodness-of-fit test showed that χ2=3.457,P=0.236.Conclusions Age,diabetes,volume overload,creatinine,lactic acid,NT-proBNP,troponin T and chloride ion levels are the risk factors for in-hospital WRF in patients with AHFrEF,and high hemoglobin is the protective fac-tor.The nomogram model based on the above factors can accurately evaluate the risk of WRF in patients with AHFrEF.
decreased ejection fractionacute heart failuredeterioration of renal functionrisk prediction model
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