A nomogram for predicting mortality of patients initially diagnosed with primary pulmonary tuberculosis in Hunan province, China: a retrospective study

Dan Li; Si-Yuan Tang; Sheng Lei; He-Bin Xie; Lin-Qi Li

doi:10.3389/fcimb.2023.1179369

A nomogram for predicting mortality of patients initially diagnosed with primary pulmonary tuberculosis in Hunan province, China: a retrospective study

Front Cell Infect Microbiol. 2023 Jun 2:13:1179369. doi: 10.3389/fcimb.2023.1179369. eCollection 2023.

Authors

Dan Li^{1

2}, Si-Yuan Tang¹, Sheng Lei³, He-Bin Xie⁴, Lin-Qi Li⁵

Affiliations

¹ Xiangya School of Nursing, Central South University, Changsha, Hunan, China.
² College of Applied Technology, Hunan Open University, Changsha, Hunan, China.
³ Interventional Radiology Center, Hunan Chest Hospital, Changsha, Hunan, China.
⁴ Department of Drug Clinical Trial Institutions, The Affiliated Changsha Central Hospital, Hengyang Medical School, University of South China, Changsha, Hunan, China.
⁵ School of Public Health, University of South China, Hengyang, China.

Abstract

Objective: According to the Global Tuberculosis Report for three consecutive years, tuberculosis (TB) is the second leading infectious killer. Primary pulmonary tuberculosis (PTB) leads to the highest mortality among TB diseases. Regretfully, no previous studies targeted the PTB of a specific type or in a specific course, so models established in previous studies cannot be accurately feasible for clinical treatments. This study aimed to construct a nomogram prognostic model to quickly recognize death-related risk factors in patients initially diagnosed with PTB to intervene and treat high-risk patients as early as possible in the clinic to reduce mortality.

Methods: We retrospectively analyzed the clinical data of 1,809 in-hospital patients initially diagnosed with primary PTB at Hunan Chest Hospital from January 1, 2019, to December 31, 2019. Binary logistic regression analysis was used to identify the risk factors. A nomogram prognostic model for mortality prediction was constructed using R software and was validated using a validation set.

Results: Univariate and multivariate logistic regression analyses revealed that drinking, hepatitis B virus (HBV), body mass index (BMI), age, albumin (ALB), and hemoglobin (Hb) were six independent predictors of death in in-hospital patients initially diagnosed with primary PTB. Based on these predictors, a nomogram prognostic model was established with high prediction accuracy, of which the area under the curve (AUC) was 0.881 (95% confidence interval [Cl]: 0.777-0.847), the sensitivity was 84.7%, and the specificity was 77.7%.Internal and external validations confirmed that the constructed model fit the real situation well.

Conclusion: The constructed nomogram prognostic model can recognize risk factors and accurately predict the mortality of patients initially diagnosed with primary PTB. This is expected to guide early clinical intervention and treatment for high-risk patients.

Keywords: initially diagnosed; mortality; nomogram; primary pulmonary tuberculosis; prognostic.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

China / epidemiology
Humans
Nomograms*
Retrospective Studies
Risk Factors
Tuberculosis, Pulmonary* / diagnosis

Grants and funding

The Science and Technology Program Foundation of Changsha (No. kq2004169); the Natural Science Foundation of Hunan Province (No. 2020JJ8044); the Scientific Research Funds of Health Commission of Hunan Province(No. 20201936).