Key result
A nomogram incorporating eight clinical variables accurately predicted 4-year survival in critically ill patients with acute myocardial infarction (validation C-index 0.762; 95% CI 0.725-0.799).
Why the study?
Acute myocardial infarction carries a poor prognosis, and a nomogram was needed to predict long-term survival in critically ill patients to guide treatment and assess disease severity.
Can a clinical nomogram accurately predict long-term survival in critically ill patients with acute myocardial infarction?
Cohort (n=1,202)
Can a clinical nomogram accurately predict long-term survival in critically ill patients with acute myocardial infarction?
Effect estimate: C-index 0.762 (95% CI 0.725-0.799)
A newly developed nomogram using 8 clinical variables can accurately predict 4-year survival in critically ill patients with acute myocardial infarction.
May aid prognostic assessment in critical AMI; leaves open external validation before clinical adoption.
PURPOSE: Acute myocardial infarction (AMI) is a common cardiovascular disease with a poor prognosis. The aim of this study was to construct a nomogram for predicting the long-term survival of critically ill patients with AMI. This nomogram will help in assessing disease severity, guiding treatment, and improving prognosis. PATIENTS AND METHODS: The clinical data of patients with AMI were extracted from the MIMIC-III v1.4 database. Cox proportional hazards models were adopted to identify independent prognostic factors. A nomogram for predicting the long-term survival of these patients was developed on the basis of the results of multifactor analysis. The discriminative ability and accuracy of the multifactor analysis were evaluated according to concordance index (C-index) and calibration curves. RESULTS: A total of 1202 patients were included in the analysis. The patients were randomly divided into a training set (n = 841) and a validation set (n = 361). Multivariate analysis revealed that age, blood urea nitrogen, respiratory rate, hemoglobin, pneumonia, cardiogenic shock, dialysis, and mechanical ventilation, all of which were incorporated into the nomogram, were independent predictive factors of AMI. Moreover, the nomogram exhibited favorable performance in predicting the 4-year survival of patients with AMI. The training set and the validation set had a C-index of 0.789 (95% confidence interval [CI]: 0.765-0.813) and 0.762 (95% CI: 0.725-0.799), respectively. CONCLUSION: The nomogram constructed herein can accurately predict the long-term survival of critically ill patients with AMI.
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Tang et al. (2021) conducted a cohort in Acute myocardial infarction (n=1,202). Nomogram incorporating age, blood urea nitrogen, respiratory rate, hemoglobin, pneumonia, cardiogenic shock, dialysis, and mechanical ventilation was evaluated on 4-year survival prediction accuracy (C-index) (C-index 0.762, 95% CI 0.725-0.799). A nomogram incorporating eight clinical variables accurately predicted 4-year survival in critically ill patients with acute myocardial infarction (validation C-index 0.762; 95% CI 0.725-0.799).
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