Development and validation of a novel combinatorial nomogram model to predict in-hospital deaths in heart failure patients

Author:

Cai Dabei,Chen Qianwen,Mu Xiaobo,Xiao Tingting,Gu Qingqing,Wang Yu,Ji Yuan,Sun Ling,Wei Jun,Wang Qingjie

Abstract

Abstract Background The purpose of this study was to develop a Nomogram model to identify the risk of all-cause mortality during hospitalization in patients with heart failure (HF). Methods HF patients who had been registered in the Medical Information Mart for Intensive Care (MIMIC) III and IV databases were included. The primary outcome was the occurrence of all-cause mortality during hospitalization. Two Logistic Regression models (LR1 and LR2) were developed to predict in-hospital death for HF patients from the MIMIC-IV database. The MIMIC-III database were used for model validation. The area under the receiver operating characteristic curve (AUC) was used to compare the discrimination of each model. Calibration curve was used to assess the fit of each developed models. Decision curve analysis (DCA) was used to estimate the net benefit of the predictive model. Results A total of 16,908 HF patients were finally enrolled through screening, of whom 2,283 (13.5%) presented with in-hospital death. Totally, 48 variables were included and analyzed in the univariate and multifactorial regression analysis. The AUCs for the LR1 and LR2 models in the test cohort were 0.751 (95% CI: 0.735∼0.767) and 0.766 (95% CI: 0.751–0.781), respectively. Both LR models performed well in the calibration curve and DCA process. Nomogram and online risk assessment system were used as visualization of predictive models. Conclusion A new risk prediction tool and an online risk assessment system were developed to predict mortality in HF patients, which performed well and might be used to guide clinical practice.

Funder

Changzhou Sci&Tech Program

National Natural Science Foundation of China

Natural Science Research of Jiangsu Higher Education Institutions of China

China Postdoctoral Science Funding Program

Changzhou High-Level Medical Talents Training Project

Technology Development Fund of Nanjing Medical University

Major Research plan of Changzhou Health Commission of Jiangsu Province of China

Publisher

Springer Science and Business Media LLC

Subject

Cardiology and Cardiovascular Medicine

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