International Journal of General Medicine (Aug 2021)

Development and Validation of Nomogram to Predict Long-Term Prognosis of Critically Ill Patients with Acute Myocardial Infarction

  • Tang Y,
  • Chen Q,
  • Zha L,
  • Feng Y,
  • Zeng X,
  • Liu Z,
  • Li F,
  • Yu Z

Journal volume & issue
Vol. Volume 14
pp. 4247 – 4257

Abstract

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Yiyang Tang,1 Qin Chen,1 Lihuang Zha,1 Yilu Feng,1 Xiaofang Zeng,1 Zhenghui Liu,2 Famei Li,1 Zaixin Yu1 1Department of Cardiology, Xiangya Hospital, Central South University, Changsha, Hunan, People’s Republic of China; 2Department of Neurology, Xiangya Hospital, Central South University, Changsha, Hunan, People’s Republic of ChinaCorrespondence: Zaixin YuDepartment of Cardiology, Xiangya Hospital, Central South University, Xiangya Road, Kaifu District, Changsha, 410008, People’s Republic of ChinaTel/Fax +86 731-8432749Email [email protected]: Acute myocardial infarction (AMI) is a common cardiovascular disease with a poor prognosis. The aim of this study was to construct a nomogram for predicting the long-term survival of critically ill patients with AMI. This nomogram will help in assessing disease severity, guiding treatment, and improving prognosis.Patients and Methods: The clinical data of patients with AMI were extracted from the MIMIC-III v1.4 database. Cox proportional hazards models were adopted to identify independent prognostic factors. A nomogram for predicting the long-term survival of these patients was developed on the basis of the results of multifactor analysis. The discriminative ability and accuracy of the multifactor analysis were evaluated according to concordance index (C-index) and calibration curves.Results: A total of 1202 patients were included in the analysis. The patients were randomly divided into a training set (n = 841) and a validation set (n = 361). Multivariate analysis revealed that age, blood urea nitrogen, respiratory rate, hemoglobin, pneumonia, cardiogenic shock, dialysis, and mechanical ventilation, all of which were incorporated into the nomogram, were independent predictive factors of AMI. Moreover, the nomogram exhibited favorable performance in predicting the 4-year survival of patients with AMI. The training set and the validation set had a C-index of 0.789 (95% confidence interval [CI]: 0.765– 0.813) and 0.762 (95% CI: 0.725– 0.799), respectively.Conclusion: The nomogram constructed herein can accurately predict the long-term survival of critically ill patients with AMI.Keywords: acute myocardial infarction, nomogram, long-term prognosis, MIMIC-III, retrospective study

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