实用临床医药杂志2024，Vol.28Issue(17)：51-55,5.DOI:10.7619/jcmp.20241933
中老年重症急性胰腺炎患者住院期间死亡预测模型的构建与验证
Construction and validation of a predictive model for in-hospital mortality in elderly patients with severe acute pancreatitis
摘要
Abstract
Objective To develop and validate a predictive model for in-hospital mortality in elderly patients with severe acute pancreatitis(SAP).Methods A total of 368 elderly SAP hospital-ized patients were selected as study objects,and were divided into mortality group(96 patients,26.09％)and survival group(272 patients,73.91％)based on their survival status during hospital-ization.Multivariable Logistic regression analysis was performed to identify influencing factors associ-ated with in-hospital mortality in SAP patients,and a predictive model was constructed based on these factors.Receiver operating characteristic(ROC)curves were plotted,and the predictive performance of the model was evaluated using the area under the curve(AUC),accuracy,sensitivity,and speci-ficity.Results Univariate analysis revealed that the mortality group had a higher proportion of pa-tients aged over 60 years,with renal insufficiency,coronary heart disease,and undergoing laparo-scopic surgery.Additionally,the mortality group had significantly higher levels of red blood cell dis-tribution width,fasting blood glucose,interleukin-6,procalcitonin,neutrophil-to-lymphocyte ratio(NLR),lactate,modified CT severity index(MCTSI)score,and bedside index for severity in acute pancreatitis(BISAP)score compared to the survival group(P＜0.05).Multivariable Logistic regression analysis identified age,renal insufficiency,MCTSI score,fasting blood glucose,and NLR as independent influencing factors of in-hospital mortality in elderly SAP patients(P＜0.05).A regression equa-tion was constructed based on these factors:C-index=-1.569+0.258 x(age)+0.334 x(renal insufficiency)+0.672 x(MCTSI score)+0.281 x(fasting blood glucose)+0.410 x(NLR).The ROC curve analysis showed that the AUC of the model for predicting in-hospital mortality in elderly SAP patients was 0.877(95％CI,0.840 to 0.915),with an accuracy of 84.23％,sensitivity of 75.00％,and specificity of 87.50％.Conclusion Age,renal insufficiency,MCTSI score,fasting blood glucose,and NLR are independent predictors of in-hospital mortality in elderly SAP patients.The predictive model constructed based on these factors can assist in identifying high-risk patients and predicting all-cause mortality risk in SAP.关键词
中老年患者/重症急性胰腺炎/死亡/预测模型/肾功能不全Key words
middle-aged and elderly patients/severe acute pancreatitis/mortality/predic-tive model/renal insufficiency分类
医药卫生引用本文复制引用
张佳旭,杨婷,李燃..中老年重症急性胰腺炎患者住院期间死亡预测模型的构建与验证[J].实用临床医药杂志,2024,28(17):51-55,5.基金项目
黑龙江省卫生健康委科研课题(2020-106) （2020-106）
