Development of a new prognostic index PNPI for prognosis prediction of CKD patients with pneumonia at hospital admission
BackgroundThe aim of this study was to investigate the relationship between pneumonia and chronic kidney disease (CKD), to elucidate potential risk factors, and to develop a new predictive model for the poor prognosis of pneumonia in CKD patients.MethodWe conducted a retrospective observational stud...
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| Format: | Article |
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Frontiers Media S.A.
2023-08-01
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| Series: | Frontiers in Medicine |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fmed.2023.1135586/full |
| _version_ | 1797745860918902784 |
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| author | Xiao-Yu Cai Jia-He Fan Yi-Chun Cheng Shu-Wang Ge Gang Xu |
| author_facet | Xiao-Yu Cai Jia-He Fan Yi-Chun Cheng Shu-Wang Ge Gang Xu |
| author_sort | Xiao-Yu Cai |
| collection | DOAJ |
| description | BackgroundThe aim of this study was to investigate the relationship between pneumonia and chronic kidney disease (CKD), to elucidate potential risk factors, and to develop a new predictive model for the poor prognosis of pneumonia in CKD patients.MethodWe conducted a retrospective observational study of CKD patients admitted to Tongji Hospital between June 2012 and June 2022. Demographic information, comorbidities or laboratory tests were collected. Applying univariate and multivariate logistic regression analyses, independent risk factors associated with a poor prognosis (i.e., respiratory failure, shock, combined other organ failure, and/or death during hospitalization) for pneumonia in CKD patients were discovered, with nomogram model subsequently developed. Predictive model was compared with other commonly used pneumonia severity scores.ResultOf 3,193 CKD patients with pneumonia, 1,013 (31.7%) met the primary endpoint during hospitalization. Risk factors predicting poor prognosis of pneumonia in CKD patients were selected on the result of multivariate logistic regression models, including chronic cardiac disease; CKD stage; elevated neutrophil to lymphocyte ratio (NLR) and D-dimer; decreased platelets, PTA, and chloride iron; and significant symptom presence and GGO presentation on CT. The nomogram model outperformed other pneumonia severity indices with AUC of 0.82 (95% CI: 0.80, 0.84) in training set and 0.83 (95% CI: 0.80, 0.86) in testing set. In addition, calibration curve and decision curve analysis (DCA) proved its efficiency and adaptability.ConclusionWe designed a clinical prediction model PNPI (pneumonia in nephropathy patients prognostic index) to assess the risk of poor prognosis in CKD patients with pneumonia, which may be generalized after more external validation. |
| first_indexed | 2024-03-12T15:29:59Z |
| format | Article |
| id | doaj.art-deb7c0138db145638005fce1c148decb |
| institution | Directory Open Access Journal |
| issn | 2296-858X |
| language | English |
| last_indexed | 2024-03-12T15:29:59Z |
| publishDate | 2023-08-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Medicine |
| spelling | doaj.art-deb7c0138db145638005fce1c148decb2023-08-10T09:22:25ZengFrontiers Media S.A.Frontiers in Medicine2296-858X2023-08-011010.3389/fmed.2023.11355861135586Development of a new prognostic index PNPI for prognosis prediction of CKD patients with pneumonia at hospital admissionXiao-Yu CaiJia-He FanYi-Chun ChengShu-Wang GeGang XuBackgroundThe aim of this study was to investigate the relationship between pneumonia and chronic kidney disease (CKD), to elucidate potential risk factors, and to develop a new predictive model for the poor prognosis of pneumonia in CKD patients.MethodWe conducted a retrospective observational study of CKD patients admitted to Tongji Hospital between June 2012 and June 2022. Demographic information, comorbidities or laboratory tests were collected. Applying univariate and multivariate logistic regression analyses, independent risk factors associated with a poor prognosis (i.e., respiratory failure, shock, combined other organ failure, and/or death during hospitalization) for pneumonia in CKD patients were discovered, with nomogram model subsequently developed. Predictive model was compared with other commonly used pneumonia severity scores.ResultOf 3,193 CKD patients with pneumonia, 1,013 (31.7%) met the primary endpoint during hospitalization. Risk factors predicting poor prognosis of pneumonia in CKD patients were selected on the result of multivariate logistic regression models, including chronic cardiac disease; CKD stage; elevated neutrophil to lymphocyte ratio (NLR) and D-dimer; decreased platelets, PTA, and chloride iron; and significant symptom presence and GGO presentation on CT. The nomogram model outperformed other pneumonia severity indices with AUC of 0.82 (95% CI: 0.80, 0.84) in training set and 0.83 (95% CI: 0.80, 0.86) in testing set. In addition, calibration curve and decision curve analysis (DCA) proved its efficiency and adaptability.ConclusionWe designed a clinical prediction model PNPI (pneumonia in nephropathy patients prognostic index) to assess the risk of poor prognosis in CKD patients with pneumonia, which may be generalized after more external validation.https://www.frontiersin.org/articles/10.3389/fmed.2023.1135586/fullchronic kidney diseasepneumoniaclinical characteristicsrisk factorsnomogram |
| spellingShingle | Xiao-Yu Cai Jia-He Fan Yi-Chun Cheng Shu-Wang Ge Gang Xu Development of a new prognostic index PNPI for prognosis prediction of CKD patients with pneumonia at hospital admission Frontiers in Medicine chronic kidney disease pneumonia clinical characteristics risk factors nomogram |
| title | Development of a new prognostic index PNPI for prognosis prediction of CKD patients with pneumonia at hospital admission |
| title_full | Development of a new prognostic index PNPI for prognosis prediction of CKD patients with pneumonia at hospital admission |
| title_fullStr | Development of a new prognostic index PNPI for prognosis prediction of CKD patients with pneumonia at hospital admission |
| title_full_unstemmed | Development of a new prognostic index PNPI for prognosis prediction of CKD patients with pneumonia at hospital admission |
| title_short | Development of a new prognostic index PNPI for prognosis prediction of CKD patients with pneumonia at hospital admission |
| title_sort | development of a new prognostic index pnpi for prognosis prediction of ckd patients with pneumonia at hospital admission |
| topic | chronic kidney disease pneumonia clinical characteristics risk factors nomogram |
| url | https://www.frontiersin.org/articles/10.3389/fmed.2023.1135586/full |
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