遵义医科大学学报2025，Vol.48Issue(3)：286-294,9.
老年心力衰竭住院患者营养不良风险预测模型的构建及验证
Construction and validation of a malnutrition risk prediction model for elderly hospitalized patients with heart failure
摘要
Abstract
Objective To construct a malnutrition risk prediction model for elderly hospitalized patients with heart failure and to verify its effect.Methods A total of 375 elderly patients with heart failure who were hospital-ized in the Department of Cardiovascular Medicine of Affiliated Hospital of Zunyi Medical University from January 2019 to December 2022 were conveniently selected as the modeling set,and they were divided into malnutrition risk group(184 cases)and normal nutrition group(191 cases)by NRS2002 assessment scale.LASSO com-bined with Logistic regression analysis was used to identify the independent risk factors of malnutrition risk and construct a nomogram model.A total of 162 elderly patients with heart failure who were hospitalized in the De-partment of Cardiovascular Medicine of the same hospital from January －July 2024 were selected as the validation set.The receiver operator characteristic curve(ROC),calibration curve,Hosmer-Lemeshow goodness-of-fit test and decision curve analysis(DCA)were used for model evaluation.Results The prevalence of malnutrition in the modeling set and the validation set was 49%and 50.6%,respectively.Coronary heart disease,age,preal-bumin,urea,and neutrophil-to-lymphocyte ratio were independent predictors of malnutrition risk in elderly hos-pitalized patients with heart failure.The area under the ROC curve of the modeling set was 0.791(95%CI:0.746 －0.837),the Hosmer-Lemeshow goodness-of-fit test showed χ2 ＝7.122,P＝0.524,and the area under the ROC curve of the validation set was 0.753(95%CI:0.676 －0.829),and the Hosmer-Lemeshow goodness-of-fit test showed χ2 ＝9.202,P＝0.326,the prediction curve and calibration curve of the modeling set were close to the ideal curve,the overall trend of the prediction curve and the calibration curve of the validation set was about the same as that of the ideal curve,the DCA curve showed that the modeling set was 16.5%－ 96.5%,and the model had a higher clinical net benefit under the risk threshold of 12.5%－71%ofthe valida-tion set.Conclusion The risk prediction model constructed in this study has a good prediction effect and can pro-vide a reference for the nutritional management of elderly hospitalized patients with heart failure.关键词
老年/心力衰竭/营养不良/预测模型/列线图Key words
elderly/heart failure/malnutrition/predictive models/nomogram分类
医药卫生引用本文复制引用
陈永梅,吴迪,卢梅,李晓娜,王信坤,陶明..老年心力衰竭住院患者营养不良风险预测模型的构建及验证[J].遵义医科大学学报,2025,48(3):286-294,9.基金项目
遵义市科技计划项目(NO:遵市科合HZ字(2022)329). （NO:遵市科合HZ字(2022）
