Infection and Drug Resistance (Aug 2020)
Development and Validation of a Model for Predicting the Risk of Death in Patients with Acinetobacter baumannii Infection: A Retrospective Study
Abstract
Hui Zhang,1 Yayun Zhao,1 Yahong Zheng,1 Qinxiang Kong,1,2 Na Lv,1 Yanyan Liu,1,3,4 Dongmei Zhao,5 Jiabin Li,1– 4 Ying Ye1 1Department of Infectious Disease, The First Affiliated Hospital of Anhui Medical University, Hefei, Anhui, People’s Republic of China; 2Department of Infectious Diseases, The Chaohu Affiliated Hospital of Anhui Medical University, Hefei, Anhui, People’s Republic of China; 3Anhui Center for Surveillance of Bacterial Resistance, Hefei, Anhui, People’s Republic of China; 4Institute of Bacterial Resistance, Anhui Medical University, Hefei, Anhui, People’s Republic of China; 5Department of Infectious Disease, The Fourth Affiliated Hospital of Anhui Medical University, Hefei, Anhui, People’s Republic of ChinaCorrespondence: Ying Ye; Jiabin Li Tel +86-551-62922713Fax +86-551-62922281Email [email protected]; [email protected]: This study aimed to develop and validate a personalized prediction model of death risk in patients with Acinetobacter baumannii (A. baumannii) infection and thus guide clinical research and support clinical decision-making.Patients and Methods: The development group is comprised of 350 patients with A. baumannii infection admitted between January 2013 and December 2015 in The First Affiliated Hospital of Anhui Medical University. Further, 272 patients in the validation group were admitted between January 2016 and December 2018. The univariate and multivariate logistic regression analyses were used to determine the independent risk factors for death with A. baumannii infection. The nomogram prediction model was established based on the regression coefficients. The discrimination of the proposed prediction model was evaluated using the area under the curve (AUC) of the receiver operating characteristic (ROC) curves and decision curve analysis (DCA). The calibration diagram was used to evaluate the calibration degree of this model.Results: The infectious source, carbapenem-resistant A. baumannii (CRAB), hypoalbuminemia, Charlson comorbidity index (CCI), and mechanical ventilation (MV) were independent risk factors for death. The AUC of the ROC curve of the two groups was 0.768 and 0.792, respectively. The net income was higher when the probability was between 30% and 80%, showing a strong discrimination capacity of the proposed model. The calibration curve swung around the 45° oblique line, indicating a high degree of calibration.Conclusion: The proposed model helped predict the risk of death from A. baumannii infection, improve the early identification of patients with a higher risk of death, and guide clinical treatment.Keywords: Acinetobacter baumannii, carbapenem resistance, prediction model, risk factors
