Infection and Drug Resistance (Jan 2023)

Nomogram Prediction Model of Hypernatremia on Mortality in Critically Ill Patients

  • Qi Z,
  • Lu J,
  • Liu P,
  • Li T,
  • Li A,
  • Duan M

Journal volume & issue
Vol. Volume 16
pp. 143 – 153

Abstract

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Zhili Qi,1,* Jiaqi Lu,2,* Pei Liu,1 Tian Li,1 Ang Li,3 Meili Duan1 1Department of Critical Care Medicine, Capital Medical University, Beijing, People’s Republic of China; 2Department of Critical Care Medicine, Beijing Ditan Hospital, Capital Medical University, Beijing, People’s Republic of China; 3Beijing Ditan Hospital, Capital Medical University, Beijing, People’s Republic of China*These authors contributed equally to the articleCorrespondence: Ang Li, Beijing Ditan Hospital, Capital Medical University, Beijing Ditan Hospital 8 Jing Shun East Street, Beijing, People’s Republic of China, Email [email protected] Meili Duan, Department of Critical Care Medicine, Beijing Friendship Hospital, Capital Medical University, No. 95 Yong’an Road, Xicheng District, Beijing, 10005, People’s Republic of China, Email [email protected]: To investigate the value of hypernatremia in the intensive care unit (ICU) for the risk prediction of mortality in severe patients.Methods: Clinical data of critically ill patients admitted to the ICU of Beijing Friendship Hospital, were collected for retrospective analysis. Univariate and multivariate logistic regression analyses were employed to analyze the influencing factors. Nomograms predicting the mortality were constructed with R software and validated with repeated sampling.Results: A total of 442 cases were eligible for this study. Hypernatremia within 48 hours of ICU admission, change in sodium concentration (CNa+) within 48 hours, septic shock, APACHE II score, hyperlactatemia within 48 hours, use of continuous renal replacement therapy (CRRT) within 48 hours, and the use of mechanical ventilation (MV) within 48 hours of ICU admission were all identified as independent risk factors for death within 28 days of ICU admission. These predictors were included in a nomogram of 28-day mortality in severe patients, which was constructed using R software.Conclusion: The nomogram could predict the individualized risk of 28-day mortality based on the above factors. The model has better discrimination and accuracy and has high clinical application value.Keywords: intensive care unit, 28 day mortality, serum sodium, hypernatremia

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