Construction and Validation of Clinical Prediction Model for Prognosis of Sepsis Patients with Cardiac Dysfunction Combined with Traditional Chinese and Western Medicine
Objective To explore the construction of clinical prognostic model for patients with sepsis complicated with cardiac dysfunction(SIMD)combined with traditional Chinese and Western medicine,and to verify the model.Method In this study,a single-center retrospective study was conducted.The Second Affiliated Hospital of Heilongjiang University of Chinese Medicine from June 2016 to January 2022 was selected as the cohort to observe the occurrence of hospitalization endpoint events.The pa-tients who died within 28 days were selected as the study group,and those who did not die were selected as the control group.The original data of SIMD patients was collected retrospectively.Results According to univariate analysis,8 predictors of integrated traditional Chinese and Western medicine[age,heart rate,sequential organ failure assessment(SOFA)score,brain natriuretic peptide(BNP),tongue color,subelingual vein,international normalized ratio(INR)and troponin]were identified as risk factors for SIMD(P＜0.05).Multivariate Logistic regression analysis showed that SOFA score,BNP and sublingual vein were independ-ent risk factors for SIMD.The K value of internal verification of the model was 0.635,and the accuracy was 0.792.The area un-der the ROC curve(AUC)was 0.802 and the 95％confidence interval was 0.742 to 0.862.When the optimal threshold was 0.561,the sensitivity of the model was 62.1％and the specificity was 88.5％.The results of internal verification of the ROC curve showed that the AUC was 0.786,the sensitivity was 77.5％and the specificity was 66.8％.Compared with those of the model,the standard deviation of ROC(ROCSD)was 0.104,the standard deviation of sensitivity(sensSD)was 0.137 and the standard deviation of specificity(SpecSD)was 0.152.Hosmer-Lemeshow goodness of fit test showed that the model had a good fit(x2=1.055,P=0.587).The calibration curve was 0.798 for the original C index(95％CI 0.738 to 0.858)and 0.783 for the corrected C index.Conclusion The prognostic model of integrated traditional Chinese and Western medicine for patients with SIMD has a good clinical application.
万方数据
维普
