摘要
目的探讨老年重症肺炎患者并发心力衰竭的影响因素,并构建风险预测列线图模型。方法选取2019年1月至2023年5月老年重症肺炎患者200例,根据是否并发心力衰竭分为未发生组(n=150)和发生组(n=50)。比较两组患者的临床资料,分析影响老年重症肺炎患者并发心力衰竭的危险因素,构建风险预测列线图模型并验证预测效能。结果两组患者年龄(>65岁)、基础心脏疾病、长期卧床、肝肾器官功能健康状况、降钙素原(PCT)>5 ng/mL比较,差异有统计学意义(P<0.05);多因素Logistic回归分析年龄(>65岁)、基础心脏疾病、长期卧床、肝肾功能不全、PCT>5 ng/mL是老年重症肺炎患者并发心力衰竭的独立危险因素;构建的风险预测列线图模型ROC曲线下的面积为0.877(95%CI:0.809~0.930),预测效能良好。结论老年重症肺炎患者并发心力衰竭的独立危险因素为年龄(>65岁)、有基础心脏疾病、长期卧床、肝肾功能不全、PCT>5 ng/mL,通过构建与验证模型发现这些影响因素具有较高准确性和区分度。
Objective To investigate the risk factors of heart failure complication in elderly patients with severe pneumonia,and construct a risk prediction column-line diagram model to validate it.Methods Two hundred elderly patients with severe pneumonia admitted to our hospital from January 2019 to May 2023 were selected,and they were divided into the non-occurrence group(n=150)and the occurrence group(n=50)according to whether they had heart failure complications.The clinical data of the two groups of patients was compared,and the risk factors affecting the complication of heart failure in elderly patients with severe pneumonia were analyzed.A risk prediction column-line diagram model and verify the prediction efficacy was constructed.Results Comparison of age(>65 years),underlying heart disease,long-term bed-ridden,liver and kidney organ function health status,and procalcitoninogen(PCT)>5 ng/mL between the two groups were statistically significant(P<0.05).Multifactorial Logistic regression analyses of age(>65 years),underlying heart disease,long-term bed-ridden,liver and kidney organ function health status,and PCT>5 ng/mL were the independent risk factors for complicated heart failure in elderly patients with severe pneumonia.The constructed risk prediction column-line graph model with area under the ROC curve was 0.877(95%CI:0.809,0.930),which had good predictive efficacy.Conclusion The independent risk factors for complicated heart failure in elderly patients with severe pneumonia were age(>65 years),presence of underlying cardiac disease,prolonged bed rest,functional health status of the liver and kidney organs,and PCT>2 ng/mL,and these influences were found to have a high degree of accuracy and differentiation by constructing and validating the model.
出处
《浙江临床医学》
2024年第8期1148-1150,共3页
Zhejiang Clinical Medical Journal
关键词
老年
重症肺炎
心力衰竭
危险因素
风险预测列线图模型
Elderly Severe pneumonia
Heart failure
Risk factors
Risk prediction column line graph model
