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Development and validation of risk prediction model for adverse outcomes in trauma patients.
Zhuang, Qian; Liu, Jianchao; Liu, Wei; Ye, Xiaofei; Chai, Xuan; Sun, Songmei; Feng, Cong; Li, Lin.
Afiliación
  • Zhuang Q; Department of Innovative Medical Research, Chinese People's Liberation Army General Hospital, Beijing, China.
  • Liu J; Department of Innovative Medical Research, Chinese People's Liberation Army General Hospital, Beijing, China.
  • Liu W; Department of Innovative Medical Research, Chinese People's Liberation Army General Hospital, Beijing, China.
  • Ye X; Department of Health Statistics, Naval Medical University, Shanghai, China.
  • Chai X; Outpatient Department, Capital Medical University Affiliated Beijing Shijitan Hospital, Beijing, China.
  • Sun S; The Second Medical Center of Chinese PLA General Hospital, Beijing, China.
  • Feng C; Department of Emergency, First Medical Center of Chinese PLA General Hospital, Beijing, China.
  • Li L; Department of Innovative Medical Research, Chinese People's Liberation Army General Hospital, Beijing, China.
Ann Med ; 56(1): 2391018, 2024 Dec.
Article en En | MEDLINE | ID: mdl-39155796
ABSTRACT

BACKGROUND:

The prognosis of trauma patients is highly dependent on early medical diagnosis. By constructing a nomogram model, the risk of adverse outcomes can be displayed intuitively and individually, which has important clinical implications for medical diagnosis.

OBJECTIVE:

To develop and evaluate models for predicting patients with adverse outcomes of trauma that can be used in different data availability settings in China.

METHODS:

This was a retrospective prognostic study using data from 8 public tertiary hospitals in China from 2018. The data were randomly divided into a development set and a validation set. Simple, improved and extended models predicting adverse outcomes were developed, with adverse outcomes defined as in-hospital death or ICU transfer, and patient clinical characteristics, vital signs, diagnoses, and laboratory test values as predictors. The results of the models were presented in the form of nomograms, and performance was evaluated using area under the receiver operating characteristic curve (ROC-AUC), precision-recall (PR) curves (PR-AUC), Hosmer-Lemeshow goodness-of-fit test, calibration curve, and decision curve analysis (DCA).

RESULTS:

Our final dataset consisted of 18,629 patients (40.2% female, mean age of 52.3), 1,089 (5.85%) of whom resulted in adverse outcomes. In the external validation set, three models achieved ROC-AUC of 0.872, 0.881, and 0.903, and a PR-AUC of 0.339, 0.337, and 0.403, respectively. In terms of the calibration curves and DCA, the models also performed well.

CONCLUSIONS:

This prognostic study found that three prediction models and nomograms including the patient clinical characteristics, vital signs, diagnoses, and laboratory test values can support clinicians in more accurately identifying patients who are at risk of adverse outcomes in different settings based on data availability.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Heridas y Lesiones / Nomogramas Límite: Adult / Aged / Female / Humans / Male / Middle aged País/Región como asunto: Asia Idioma: En Revista: Ann Med Asunto de la revista: MEDICINA Año: 2024 Tipo del documento: Article País de afiliación: China Pais de publicación: Reino Unido
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Heridas y Lesiones / Nomogramas Límite: Adult / Aged / Female / Humans / Male / Middle aged País/Región como asunto: Asia Idioma: En Revista: Ann Med Asunto de la revista: MEDICINA Año: 2024 Tipo del documento: Article País de afiliación: China Pais de publicación: Reino Unido