Construction and Evaluation of a Predictive Model for Liver Injury Associated with Heatstroke: A Multicenter Retrospective Study

IF 2.2 4区 医学 Q2 MEDICINE, GENERAL & INTERNAL International Journal of Clinical Practice Pub Date : 2024-08-09 DOI:10.1155/2024/6485323
Hongguang Gao, Guo Tang, Sha Yang, Ying Yang, Jie Sheng, Rong Yao
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Abstract

Background. Liver injury related to heatstroke plays a pivotal role in secondary multiorgan damage and is a direct cause of mortality in affected patients of heatstroke. This study was designed to identify independent risk factors associated with liver injury in heatstroke and to construct a clinically applicable predictive model. Methods. We conducted a retrospective analysis of 188 patients diagnosed with heatstroke, treated in the emergency departments of eight medical institutions from July 1, 2022, to September 30, 2023. Patients were categorized into a liver injury group (n = 80) and a nonliver injury group (n = 108), based on liver function indices recorded during hospitalization. Lasso regression was employed for variable refinement, while multifactorial logistic regression was utilized to identify independent risk factors for liver injury in heatstroke and to construct a nomogram model. The model’s efficacy was evaluated using the C-index, calibration curves, and decision curve analysis, examining its discriminative ability, calibration, and clinical utility. Results. The nomogram included predictive factors such as the Glasgow score, absolute lymphocyte count, lactate dehydrogenase levels, and creatine kinase isoenzyme. The model showed high accuracy and discriminative capability. The C-index was 0.852 (95% CI 0.80–0.905) with a calibration index of 0.843. Decision curve analysis revealed significant clinical applicability for this nomogram. Conclusion. The study identified four key independent risk factors for liver injury in heatstroke patients. The constructed nomogram, based on the four clinical indicators, demonstrated robust predictive accuracy, discriminative power, and clinical relevance.

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构建和评估与中暑相关的肝损伤预测模型:一项多中心回顾性研究
背景。与中暑有关的肝损伤在继发性多器官损伤中起着关键作用,是中暑患者死亡的直接原因。本研究旨在确定与中暑肝损伤相关的独立风险因素,并构建一个适用于临床的预测模型。研究方法我们对2022年7月1日至2023年9月30日期间在8家医疗机构急诊科接受治疗的188名确诊为中暑的患者进行了回顾性分析。根据住院期间记录的肝功能指数,将患者分为肝损伤组(80 人)和非肝损伤组(108 人)。采用拉索回归对变量进行细化,同时利用多因素逻辑回归确定中暑肝损伤的独立风险因素,并构建一个提名图模型。利用 C 指数、校准曲线和决策曲线分析对模型的有效性进行了评估,考察了其鉴别能力、校准和临床实用性。结果。提名图包括格拉斯哥评分、绝对淋巴细胞计数、乳酸脱氢酶水平和肌酸激酶同工酶等预测因素。该模型显示出较高的准确性和判别能力。C指数为0.852(95% CI 0.80-0.905),校准指数为0.843。决策曲线分析表明,该提名图具有显著的临床适用性。结论该研究确定了中暑患者肝损伤的四个关键独立风险因素。根据这四个临床指标构建的提名图显示了强大的预测准确性、鉴别力和临床相关性。
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来源期刊
CiteScore
5.30
自引率
0.00%
发文量
274
审稿时长
3-8 weeks
期刊介绍: IJCP is a general medical journal. IJCP gives special priority to work that has international appeal. IJCP publishes: Editorials. IJCP Editorials are commissioned. [Peer reviewed at the editor''s discretion] Perspectives. Most IJCP Perspectives are commissioned. Example. [Peer reviewed at the editor''s discretion] Study design and interpretation. Example. [Always peer reviewed] Original data from clinical investigations. In particular: Primary research papers from RCTs, observational studies, epidemiological studies; pre-specified sub-analyses; pooled analyses. [Always peer reviewed] Meta-analyses. [Always peer reviewed] Systematic reviews. From October 2009, special priority will be given to systematic reviews. [Always peer reviewed] Non-systematic/narrative reviews. From October 2009, reviews that are not systematic will be considered only if they include a discrete Methods section that must explicitly describe the authors'' approach. Special priority will, however, be given to systematic reviews. [Always peer reviewed] ''How to…'' papers. Example. [Always peer reviewed] Consensus statements. [Always peer reviewed] Short reports. [Always peer reviewed] Letters. [Peer reviewed at the editor''s discretion] International scope IJCP publishes work from investigators globally. Around 30% of IJCP articles list an author from the UK. Around 30% of IJCP articles list an author from the USA or Canada. Around 45% of IJCP articles list an author from a European country that is not the UK. Around 15% of articles published in IJCP list an author from a country in the Asia-Pacific region.
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