Development and validation of nomogram for unplanned ICU admission in patients with dilated cardiomyopathy

Xiao-Lei Li; Dilare Adi; Qian Zhao; Aibibanmu Aizezi; Munawaer Keremu; Yan-Peng Li; Fen Liu; Xiang Ma; Xiao-Mei Li; Adila Azhati; Yi-Tong Ma

doi:10.3389/fcvm.2023.1043274

Development and validation of nomogram for unplanned ICU admission in patients with dilated cardiomyopathy

Front Cardiovasc Med. 2023 Mar 16:10:1043274. doi: 10.3389/fcvm.2023.1043274. eCollection 2023.

Authors

Xiao-Lei Li^{1

2}, Dilare Adi^{1

2}, Qian Zhao^{1

2}, Aibibanmu Aizezi^{1

2}, Munawaer Keremu^{1

2}, Yan-Peng Li^{1

2}, Fen Liu^{1

2}, Xiang Ma^{1

2}, Xiao-Mei Li^{1

2}, Adila Azhati³, Yi-Tong Ma^{1

2}

Affiliations

¹ State Key Laboratory of Pathogenesis, Prevention and Treatment of High Incidence Diseases in Central Asia, Department of Cardiology, First Affiliated Hospital of Xinjiang Medical University, Urumqi, China.
² Xinjiang Key Laboratory of Cardiovascular Disease, Clinical Medical Research Institute, First Affiliated Hospital of Xinjiang Medical University, Urumqi, China.
³ The Emergency Center, First Affiliated Hospital of Xinjiang Medical University, Urumqi, China.

Abstract

Objective: Unplanned admission to the intensive care unit (ICU) is the major in-hospital adverse event for patients with dilated cardiomyopathy (DCM). We aimed to establish a nomogram of individualized risk prediction for unplanned ICU admission in DCM patients.

Methods: A total of 2,214 patients diagnosed with DCM from the First Affiliated Hospital of Xinjiang Medical University from January 01, 2010, to December 31, 2020, were retrospectively analyzed. Patients were randomly divided into training and validation groups at a 7:3 ratio. The least absolute shrinkage and selection operator and multivariable logistic regression analysis were used for nomogram model development. The area under the receiver operating characteristic curve, calibration curves, and decision curve analysis (DCA) were used to evaluate the model. The primary outcome was defined as unplanned ICU admission.

Results: A total of 209 (9.44%) patients experienced unplanned ICU admission. The variables in our final nomogram included emergency admission, previous stroke, New York Heart Association Class, heart rate, neutrophil count, and levels of N-terminal pro b-type natriuretic peptide. In the training group, the nomogram showed good calibration (Hosmer-Lemeshow χ ²= 14.40, P = 0.07) and good discrimination, with an optimal-corrected C-index of 0.76 (95% confidence interval: 0.72-0.80). DCA confirmed the clinical net benefit of the nomogram model, and the nomogram maintained excellent performances in the validation group.

Conclusion: This is the first risk prediction model for predicting unplanned ICU admission in patients with DCM by simply collecting clinical information. This model may assist physicians in identifying individuals at a high risk of unplanned ICU admission for DCM inpatients.

Keywords: dilated cardiomyopathy; nomogram; prediction model; prognosis; unplanned ICU admission.

Grants and funding

This study was supported by grants from the Central Guide on Local Science and Technology Development Fund of the Xinjiang Province (ZYYD2022A01) and the National Natural Science Foundation of China (91957208 and 81960046).