国际护理科学（英文）2023，Vol.10Issue(2)：142-150,9.
老年心力衰竭住院患者衰弱风险动态诺谟图的构建及验证
Development and validation of dynamic nomogram of frailty risk for older patients hospitalized with heart failure
摘要
Abstract
Objective:This study aimed to establish and validate a dynamic online nomograph for predicting the risk of frailty in older patients hospitalized with heart failure in China.Methods:A total of 451 older adults with heart failure hospitalized were selected between December 2021 and November 2022 at the Department of Cardiovascular Medicine in a Class A tertiary hospital in Shandong,China.The data of patients were obtained by using Barthel Index,instrumental activity of daily living scale,mini nutrition assessment-short form,Pittsburgh sleep quality index scale,Morse fall risk assessment scale and general information scale.The brain natriuretic peptide and echocardiographic indexes of patients were collected by electronic medical records.All participants were randomly divided into the training set(n=319)and the validation set(n=132)at the ratio of 7:3.The training set is used for model construction,and the validation set is used for internal validation.Using the Least Absolute Shrinkage and Selection Operator(LASSO)regression method to filter modeling variables,while the multivariable logistic regression was used to establish the nomogram based on the screened optimal variables.The performance of the model was evaluated by the area under the curve(AUC)of the receiver operator characteristic(ROC)curve,Hosmer-Lemeshow test,calibration plot,and decision curve analysis(DCA).Results:The prevalence of frailty in 451 patients was 50.6％,51.4％,and 48.5％in the training and vali-dation sets,respectively.Drinking,grip strength,New York Heart Association(NYHA)class,multi-morbidity,hospitalization history of heart failure,Barthel Index,the instrumental activities of daily living,nutritional status,sleep,fall,and left atrial end-diastolic diameter were used for LASSO regression analysis as the significant predictors of frailty.According to internal validation,the AUC of the ROC curve for the nomogram was 0.920,with a sensitivity of 86.8％and specificity of 84.4％.Moreover,in the validation set,the P-values of the H-L test were 0.742,and the calibration curve had good concordance between the estimated frailty risk and actual observation,indicating the model was well-calibrated.The DCA results confirmed that the nomogram had a well-performance in clinical suitability.Conclusions:An online dynamic nomogram predicting frailty for older patients hospitalized for heart failure in China was well-established and identified in this study.This model benefits medical pro-fessionals in identifying high-risk frailty in older hospitalized patients with heart failure,which could reduce the medical and disease burden of heart failure to a certain extent.However,further verification is needed in the future.关键词
老年人/衰弱/心力衰竭/病人/列线图Key words
Aged/Frailty/Heart failure/Patients/Nomogram引用本文复制引用
李倩,张兰娥,陈延萍,秦德春,李淑梅,张侍玉,方柳,朱家峰,王颖超,毛雅楠..老年心力衰竭住院患者衰弱风险动态诺谟图的构建及验证[J].国际护理科学（英文）,2023,10(2):142-150,9.基金项目
This study was supported by the Nursing Research Fund of Weifang Medical University(2022MS001). （2022MS001）
