A nomogram for predicting risk of death during hospitalization in elderly patients with Alzheimer's disease at the time of admission.

Alzheimer's disease comorbidity in-hospital mortality nomogram predictive model

Journal

Frontiers in neurology
ISSN: 1664-2295
Titre abrégé: Front Neurol
Pays: Switzerland
ID NLM: 101546899

Informations de publication

Date de publication:
2023
Historique:
received: 08 11 2022
accepted: 01 02 2023
entrez: 6 3 2023
pubmed: 7 3 2023
medline: 7 3 2023
Statut: epublish

Résumé

Elderly patients with Alzheimer's disease (AD) often have multiple underlying disorders that lead to frequent hospital admissions and are associated with adverse outcomes such as in-hospital mortality. The aim of our study was to develop a nomogram to be used at hospital admission for predicting the risk of death in patients with AD during hospitalization. We established a prediction model based on a dataset of 328 patients hospitalized with AD -who were admitted and discharged from January 2015 to December 2020. A multivariate logistic regression analysis method combined with a minimum absolute contraction and selection operator regression model was used to establish the prediction model. The identification, calibration, and clinical usefulness of the predictive model were evaluated using the C-index, calibration diagram, and decision curve analysis. Internal validation was evaluated using bootstrapping. The independent risk factors included in our nomogram were diabetes, coronary heart disease (CHD), heart failure, hypotension, chronic obstructive pulmonary disease (COPD), cerebral infarction, chronic kidney disease (CKD), anemia, activities of daily living (ADL) and systolic blood pressure (SBP). The C-index and AUC of the model were both 0.954 (95% CI: 0.929-0.978), suggesting that the model had accurate discrimination ability and calibration. Internal validation achieved a good C-index of 0.940. The nomogram including the comorbidities (i.e., diabetes, CHD, heart failure, hypotension, COPD, cerebral infarction, anemia and CKD), ADL and SBP can be conveniently used to facilitate individualized identification of risk of death during hospitalization in patients with AD.

Sections du résumé

Background and objectives UNASSIGNED
Elderly patients with Alzheimer's disease (AD) often have multiple underlying disorders that lead to frequent hospital admissions and are associated with adverse outcomes such as in-hospital mortality. The aim of our study was to develop a nomogram to be used at hospital admission for predicting the risk of death in patients with AD during hospitalization.
Methods UNASSIGNED
We established a prediction model based on a dataset of 328 patients hospitalized with AD -who were admitted and discharged from January 2015 to December 2020. A multivariate logistic regression analysis method combined with a minimum absolute contraction and selection operator regression model was used to establish the prediction model. The identification, calibration, and clinical usefulness of the predictive model were evaluated using the C-index, calibration diagram, and decision curve analysis. Internal validation was evaluated using bootstrapping.
Results UNASSIGNED
The independent risk factors included in our nomogram were diabetes, coronary heart disease (CHD), heart failure, hypotension, chronic obstructive pulmonary disease (COPD), cerebral infarction, chronic kidney disease (CKD), anemia, activities of daily living (ADL) and systolic blood pressure (SBP). The C-index and AUC of the model were both 0.954 (95% CI: 0.929-0.978), suggesting that the model had accurate discrimination ability and calibration. Internal validation achieved a good C-index of 0.940.
Conclusion UNASSIGNED
The nomogram including the comorbidities (i.e., diabetes, CHD, heart failure, hypotension, COPD, cerebral infarction, anemia and CKD), ADL and SBP can be conveniently used to facilitate individualized identification of risk of death during hospitalization in patients with AD.

Identifiants

pubmed: 36873432
doi: 10.3389/fneur.2023.1093154
pmc: PMC9978216
doi:

Types de publication

Journal Article

Langues

eng

Pagination

1093154

Informations de copyright

Copyright © 2023 Yao, Wang, Ma, He, Zhao, Zou, Weng and Yao.

Déclaration de conflit d'intérêts

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

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Auteurs

Kecheng Yao (K)

Department of Geriatrics, The People's Hospital of China Three Gorges University, Yichang, Hubei, China.

Junpeng Wang (J)

Department of Geriatrics, The People's Hospital of China Three Gorges University, Yichang, Hubei, China.

Baohua Ma (B)

Department of Medical Record, The People's Hospital of China Three Gorges University, Yichang, Hubei, China.

Ling He (L)

Department of General Practice, The People's Hospital of China Three Gorges University, Yichang, Hubei, China.

Tianming Zhao (T)

Department of Respiratory and Critical Care Medicine, The People's Hospital of China Three Gorges University, Yichang, Hubei, China.

Xiulan Zou (X)

Department of Geriatrics, The People's Hospital of China Three Gorges University, Yichang, Hubei, China.

Zean Weng (Z)

Department of Neurology, The First College of Clinical Medical Sciences, Three Gorges University, Yichang, Hubei, China.

Rucheng Yao (R)

Department of Hepatopancreatobilary Surgery, The First College of Clinical Medical Sciences, Three Gorges University, Yichang, Hubei, China.

Classifications MeSH