A Novel Nomogram based on Hemodynamic Monitoring for Predicting Survival of Patients with Acute Myocardial Infarction: An Analysis Based on the MIMIC-III Database.

Abstract

Abstract Background Acute myocardial infarction (AMI) is a common cause of mortality in intensive care unit (ICU) patients, which is often accompanied by hemodynamic instability. We aimed to develop a nomogram integrated hemodynamic parameters to predict both short-term and long-term overall survival of patients with AMI. Methods 1606 AMI patients from the Medical Information Mart for Intensive Care III database were retrospectively enrolled, all of whom underwent hemodynamic measurement within 24 h of ICU admission. In the primary cohort, a predictive nomogram based on least absolute shrinkage and selection operator (LASSO) regression analysis and multivariate Cox regression analysis was constructed to identify prognostic factors for the overall survival of AMI patients. Results LASSO and Cox regression analysis showed that systolic blood pressure, central venous pressure, systemic vascular resistance index, left ventricular stroke work, heart rate and oxygen saturation were satisfied to establish the prediction nomogram. The AUC of the model was 0.710 (95% CI: 0.664 to 0.755) for the primary cohort and 0.704 (95% CI: 0.637 to 0.771) for the validation cohort. The time-dependent AUC did not decrease significantly over time within 1 year (fluctuates around 0.7). Moreover, calibration curves, decision curve and survival curves for 7 days, 14 days, 30 days and 1 year demonstrated that this validated nomogram could provide a good predictive value for patients with AMI by combining multiple hemodynamic parameters. Conclusions Our nomogram based on multiple hemodynamic parameters has a good predict value for the survival of AMI patients.