| Popis: |
Background: Sepsis is a common clinical disease with a high mortality rate, and the prognosis of older patients with sepsis varies. The purpose of this study was to determine the prognostic factors in older patients with sepsis and to establish a prognostic model for predicting short-term mortality in older adults with sepsis, as early intervention is recommended to reduce case fatality rate. Methods: We reviewed 426 older patients with sepsis and collected their demographic details, clinical information, and data on biological markers for the first time within 24 hours of hospital admission. At the same time, we calculated a Nutrition Risk Screening (NRS-2002) score. In a 7:3 ratio, these patients were randomly divided into a training group (n = 298) and validation group (n = 128). The lasso regression model was used to reduce data dimensions and select features. To construct a prognostic signature, Cox regression analysis was used, based on which a nomogram was developed, and its predictive accuracy was evaluated. The discrimination, calibration, and clinical usefulness of the nomogram were assessed using calibration curves and decision curve analysis (DCA). Results: Albumin (ALB) level, blood urea nitrogen (BUN) level, lactic acid level, and NRS-2002 score were independent risk factors that affected the 30-day prognosis of older patients with sepsis (P＜0.05). The area under the receiver operating characteristic (ROC) curve (AUC) values of the nomogram of the training and validation groups were 0.772 (95% CI, 0.734-0.812) and 0.730 (95% CI, 0.695–0.766), respectively. The calibration curves fit well in the two groups. Conclusions: We developed and validated a prognostic nomogram model based on ALB, BUN, and lactic acid levels and NRS-2002 score for older patients with sepsis. This model can help clinicians timely assess the early risk of death in older patients with sepsis and accordingly take proactive measures. |
