基于列线图的维持性血液透析患者生存预后预测

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Abstract Objective To develop and validate an easy-to-use assessment tool for predicting short-term survival in maintenance hemodialysis (MHD) patients. Method The clinical data of MHD patients undergoing regular dialysis at the Dialysis Center of the Fourth Hospital of Changsha City from January 2018 to December 2022 were retrospectively analyzed. A total of 543 MHD patients were enrolled and randomly allocated into the training cohort (380 patients) and the validation cohort (163 patients) at a 7: 3 ratio. Least absolute shrinkage and selection operator (LASSO) regression and Cox multifactor regression analysis were employed to identify predictors and construct a nomogram. The nomogram's performance was assessed through the C-index, receiver operating curve (ROC), area under the curve (AUC), and calibration curve. Results Cox multivariate regression analysis revealed that age (HR=1.03, 95% CI 1.01-1.05), duration of dialysis (HR=0.95, 95% CI 0.93-0.96), serum ferritin<21.8 ng/mL (HR=0.68, 95% CI 0.09-4.98), 274.66 ng/mL<serum ferritin ≤500 ng/mL (HR=1.72, 95% CI 0.94-3.12), and serum ferritin>500 ng/mL (HR=2.36, 95% CI 1.50-3.72) were statistically significant. The cross-validation on the nomogram demonstrated a C-index of 0.802 for the training cohort and 0.838 for the validation cohort, indicating a strong discriminatory capability. Discrimination ability in both cohorts was favorable (the 1-year AUC in the training cohort and the validation cohort were 0.909 and 0.948, respectively; The 3-year AUC was 0.899 and 0.928, respectively). Calibration curves for both training and validation cohorts exhibited excellent alignment, underscoring the model's robust predictive performance. Conclusion Utilizing three widely employed clinical indicators—age, duration of dialysis, and serum ferritin. We developed a nomogram capable of predicting the 1-year and 3-year survival rates of MHD patients. This nomogram holds significant clinical potential and can be effectively applied in clinical practice.

Key words： maintenance hemodialysis (MHD) nomogram prediction model all-cause mortality survival rate

Received: 22 January 2024

PACS:	R692.5
	R459.5

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	Articles by authors
	DENG Tianjiao
	JIANG Yafen
	ZHANG Qingyun
	WU Rong
	LI Zhengqi
	ZHANG Lin

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DENG Tianjiao,JIANG Yafen,ZHANG Qingyun等. Prediction of survival and prognosis of maintenance hemodialysis patients based on nomogram[J]. HuNan ShiFan DaXue XueBao(YiXueBan), 2024, 21(2): 107-113.

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http://yxb.hunnu.edu.cn/EN/ OR http://yxb.hunnu.edu.cn/EN/Y2024/V21/I2/107

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