A nomogram for predicting sepsis-associated delirium: a retrospective study in MIMIC III
Abstract Objective To develop a nomogram for predicting the occurrence of sepsis-associated delirium (SAD). Materials and methods Data from a total of 642 patients were retrieved from the Medical Information Mart for Intensive Care (MIMIC III) database to build a prediction model. Multivariate logis...
| Main Authors: | , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
BMC
2023-09-01
|
| Series: | BMC Medical Informatics and Decision Making |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12911-023-02282-5 |
| _version_ | 1797452397629407232 |
|---|---|
| author | Qiong Gu Shucong Yang DanTing Fei Yuting Lu Huijie Yu |
| author_facet | Qiong Gu Shucong Yang DanTing Fei Yuting Lu Huijie Yu |
| author_sort | Qiong Gu |
| collection | DOAJ |
| description | Abstract Objective To develop a nomogram for predicting the occurrence of sepsis-associated delirium (SAD). Materials and methods Data from a total of 642 patients were retrieved from the Medical Information Mart for Intensive Care (MIMIC III) database to build a prediction model. Multivariate logistic regression was performed to identify independent predictors and establish a nomogram to predict the occurrence of SAD. The performance of the nomogram was assessed in terms of discrimination and calibration by bootstrapping with 1000 resamples. Results Multivariate logistic regression identified 4 independent predictors for patients with SAD, including Sepsis-related Organ Failure Assessment(SOFA) (p = 0.004; OR: 1.131; 95% CI 1.040 to 1.231), mechanical ventilation (P < 0.001; OR: 3.710; 95% CI 2.452 to 5.676), phosphate (P = 0.047; OR: 1.165; 95% CI 1.003 to 1.358), and lactate (P = 0.023; OR: 1.135; 95% CI 1.021 to 1.270) within 24 h of intensive care unit (ICU) admission. The area under the curve (AUC) of the predictive model was 0.742 in the training set and 0.713 in the validation set. The Hosmer − Lemeshow test showed that the model was a good fit (p = 0.471). The calibration curve of the predictive model was close to the ideal curve in both the training and validation sets. The DCA curve also showed that the predictive nomogram was clinically useful. Conclusion We constructed a nomogram for the personalized prediction of delirium in sepsis patients, which had satisfactory performance and clinical utility and thus could help clinicians identify patients with SAD in a timely manner, perform early intervention, and improve their neurological outcomes. |
| first_indexed | 2024-03-09T15:07:56Z |
| format | Article |
| id | doaj.art-874ba95bb8034de588184ba69c21a9fe |
| institution | Directory Open Access Journal |
| issn | 1472-6947 |
| language | English |
| last_indexed | 2024-03-09T15:07:56Z |
| publishDate | 2023-09-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Medical Informatics and Decision Making |
| spelling | doaj.art-874ba95bb8034de588184ba69c21a9fe2023-11-26T13:32:16ZengBMCBMC Medical Informatics and Decision Making1472-69472023-09-012311910.1186/s12911-023-02282-5A nomogram for predicting sepsis-associated delirium: a retrospective study in MIMIC IIIQiong Gu0Shucong Yang1DanTing Fei2Yuting Lu3Huijie Yu4Department of Emergency Medicine, The First Hospital of Jiaxing/Affiliated Hospital of Jiaxing UniversityDepartment of Emergency Medicine, The First Hospital of Jiaxing/Affiliated Hospital of Jiaxing UniversityDepartment of Emergency Medicine, The First Hospital of Jiaxing/Affiliated Hospital of Jiaxing UniversityDepartment of Emergency Medicine, The First Hospital of Jiaxing/Affiliated Hospital of Jiaxing UniversityDepartment of Emergency Medicine, The First Hospital of Jiaxing/Affiliated Hospital of Jiaxing UniversityAbstract Objective To develop a nomogram for predicting the occurrence of sepsis-associated delirium (SAD). Materials and methods Data from a total of 642 patients were retrieved from the Medical Information Mart for Intensive Care (MIMIC III) database to build a prediction model. Multivariate logistic regression was performed to identify independent predictors and establish a nomogram to predict the occurrence of SAD. The performance of the nomogram was assessed in terms of discrimination and calibration by bootstrapping with 1000 resamples. Results Multivariate logistic regression identified 4 independent predictors for patients with SAD, including Sepsis-related Organ Failure Assessment(SOFA) (p = 0.004; OR: 1.131; 95% CI 1.040 to 1.231), mechanical ventilation (P < 0.001; OR: 3.710; 95% CI 2.452 to 5.676), phosphate (P = 0.047; OR: 1.165; 95% CI 1.003 to 1.358), and lactate (P = 0.023; OR: 1.135; 95% CI 1.021 to 1.270) within 24 h of intensive care unit (ICU) admission. The area under the curve (AUC) of the predictive model was 0.742 in the training set and 0.713 in the validation set. The Hosmer − Lemeshow test showed that the model was a good fit (p = 0.471). The calibration curve of the predictive model was close to the ideal curve in both the training and validation sets. The DCA curve also showed that the predictive nomogram was clinically useful. Conclusion We constructed a nomogram for the personalized prediction of delirium in sepsis patients, which had satisfactory performance and clinical utility and thus could help clinicians identify patients with SAD in a timely manner, perform early intervention, and improve their neurological outcomes.https://doi.org/10.1186/s12911-023-02282-5SepsisSepsis-associated deliriumDeliriumNomogram |
| spellingShingle | Qiong Gu Shucong Yang DanTing Fei Yuting Lu Huijie Yu A nomogram for predicting sepsis-associated delirium: a retrospective study in MIMIC III BMC Medical Informatics and Decision Making Sepsis Sepsis-associated delirium Delirium Nomogram |
| title | A nomogram for predicting sepsis-associated delirium: a retrospective study in MIMIC III |
| title_full | A nomogram for predicting sepsis-associated delirium: a retrospective study in MIMIC III |
| title_fullStr | A nomogram for predicting sepsis-associated delirium: a retrospective study in MIMIC III |
| title_full_unstemmed | A nomogram for predicting sepsis-associated delirium: a retrospective study in MIMIC III |
| title_short | A nomogram for predicting sepsis-associated delirium: a retrospective study in MIMIC III |
| title_sort | nomogram for predicting sepsis associated delirium a retrospective study in mimic iii |
| topic | Sepsis Sepsis-associated delirium Delirium Nomogram |
| url | https://doi.org/10.1186/s12911-023-02282-5 |
| work_keys_str_mv | AT qionggu anomogramforpredictingsepsisassociateddeliriumaretrospectivestudyinmimiciii AT shucongyang anomogramforpredictingsepsisassociateddeliriumaretrospectivestudyinmimiciii AT dantingfei anomogramforpredictingsepsisassociateddeliriumaretrospectivestudyinmimiciii AT yutinglu anomogramforpredictingsepsisassociateddeliriumaretrospectivestudyinmimiciii AT huijieyu anomogramforpredictingsepsisassociateddeliriumaretrospectivestudyinmimiciii AT qionggu nomogramforpredictingsepsisassociateddeliriumaretrospectivestudyinmimiciii AT shucongyang nomogramforpredictingsepsisassociateddeliriumaretrospectivestudyinmimiciii AT dantingfei nomogramforpredictingsepsisassociateddeliriumaretrospectivestudyinmimiciii AT yutinglu nomogramforpredictingsepsisassociateddeliriumaretrospectivestudyinmimiciii AT huijieyu nomogramforpredictingsepsisassociateddeliriumaretrospectivestudyinmimiciii |