摘要
目的探讨病毒性肺炎合并急性呼吸窘迫综合征(ARDS)患者的临床特征,并建立病毒性肺炎合并ARDS患者预后的列线图模型。方法选取2017年6月-2020年2月进入新乡市中心医院进行诊治的病毒性肺炎合并ARDS患者276例作为研究对象,采用Logistic回归分析筛选病毒性肺炎合并ARDS患者预后的危险因素,采用R软件建立病毒性肺炎合并ARDS患者预后的列线图模型。结果276例病毒性肺炎合并急性呼吸窘迫综合征患者中有120例患者死亡,病死率为43.48%。Logistic回归分析结果显示,年龄≥60岁、起病至确诊时间>24 h、重度ARDS、机械通气时间<10 d、住院时间<14 d、氧合指数<100及GATA2基因突变等是病毒性肺炎合并ARDS患者预后的危险因素(P<0.05)。列线图模型预测病毒性肺炎合并ARDS患者死亡的受试者工作特征(ROC)曲线下面积为0.748(95%CI:0.723~0.773);内部验证的结果显示模型一致性指数(C-index)为0.766(95%CI:0.737~0.795),校准曲线显示该模型的预测结果同实际值具有较好的一致性。结论本研究构建的病毒性肺炎合并ARDS患者预后列线图模型具有较高的准确性。
OBJECTIVE To investigate the clinical characteristics in patients with viral pneumonia complicated with acute respiratory distress syndrome(ARDS),and to establish an nomogram model for the prognosis of patients with viral pneumonia complicated with ARDS.METHODS Total of 276 patients with viral pneumonia and ARDS who admitted to Xinxiang Central Hospital from Jun 2017 to Feb 2020 were recruited.Multivariate Logistic regression analysis was used to screen the risk factors for the prognosis of patients with viral pneumonia and ARDS,and R software was used to establish a nomograph model for the prognosis of patients with viral pneumonia and ARDS.RESULTS Among the 276 patients with viral pneumonia complicated with acute respiratory distress syndrome,120 patients died,with the fatality rate of 43.48%.Multivariate logistic regression analysis showed that age≥60 years,time from onset to diagnosis>24 hours,severe ARDS,mechanical ventilation time<10 days,hospitalization time<14 days,oxygenation index<100 and GATA2 gene mutation were the risk factors for the poor prognosis of patients with viral pneumonia complicated with ARDS(P<0.05).The area under the ROC curve predicted by nomogram model for the death of patients with viral pneumonia and ARDS was 0.748(95%CI:0.723-0.773).The results of internal validation showed that the model consistency index(C-index)was 0.766(95%CI:0.737-0.795),and the calibration curve showed good consistency between predicted results of the model and the actual values.CONCLUSION The nomograph model of prognosis of patients with viral pneumonia and ARDS constructed in this study has high accuracy.
作者
徐震
王昭
张海生
帖永新
XU Zhen;WANG Zhao;ZHANG Hai-sheng;TIE Yong-xin(Xinciang Central Hospital/The Fourth Clinical College of Xinciang Medical University,Xinciang,Henan 453000,China)
出处
《中华医院感染学杂志》
CAS
CSCD
北大核心
2023年第8期1143-1147,共5页
Chinese Journal of Nosocomiology
基金
河南省重点科技攻关项目(152102310210)
新乡市重点科技攻关计划项目(ZG12020)。
关键词
急性呼吸窘迫综合征
病毒性肺炎
预后
危险因素
列线图
Acute respiratory distress syndrome
Viral pneumonia
Prognosis
Risk factors
Nomogram
