Development of a nomogram model to predict 30-day mortality in ICU cancer patients with acute pulmonary embolism

被引：0

作者：

Shuangping Li ^{[1
]}

Shenshen Huang ^{[1
]}

Yuxuan Feng ^{[1
]}

Yimin Mao ^{[2
]}

机构：

[1] College of Clinical Medicine, The First Affiliated Hospital, Henan University of Science and Technology, Henan, Luoyang

[2] Department of Respiratory and Critical Care Medicine, The First Affiliated Hospital, Henan University of Science and Technology, Henan, Luoyang

来源：

Scientific Reports | / 15卷 / 1期

关键词：

30-day mortality; Cancer and acute pulmonary embolism; Nomogram; sPESI;

D O I：

10.1038/s41598-025-93907-4

中图分类号：

学科分类号：

摘要：

Cancer patients with acute pulmonary embolism (APE) admitted to the intensive care unit (ICU) face a high short-term mortality rate. The simplified pulmonary embolism severity index (sPESI) is tool for predicting adverse outcomes. However, its effectiveness in ICU cancer patients with APE remains unclear. This study aimed to validate the sPESI score and develop a predictive model for 30-day mortality in this specific patient group. We conducted a retrospective analysis using data from the MIMIC-IV database, focusing on ICU patients with cancer and APE. The primary outcome of interest was 30-day mortality. Predictors were initially selected using Least Absolute Shrinkage and Selection Operator (LASSO) analysis. A multivariable logistic regression model was then developed. The performance of the nomogram was assessed using calibration, decision curve analysis (DCA), and receiver operating characteristic (ROC) curve analysis to evaluate accuracy, clinical utility, and discrimination, respectively. A total of 286 cancer patients with APE were included in the study, with an average age of 68.9 years; the cohort comprised 137 males (47.9%) and 149 females (52.1%), and the 30-day mortality rate was 32.2%. Multivariable logistic regression analysis identified SOFA score, tumor metastasis, hemoglobin level, anion gap, weight and the prevalence of liver disease as independent predictors of 30-day mortality. The area under the curves (AUCs) of ROC for sPESI and the nomogram model were 0.568 (95% CI, 0.500-0.637) and 0.761 (95% CI, 0.701–0.821). The nomogram model had a higher predictive value for 30-day mortality in patients with acute pulmonary embolism and cancer compared to the sPESI score (P < 0.05). We developed a nomogram to predict the probability of 30-day mortality for ICU patients with acute pulmonary embolism and cancer. This nomogram demonstrated robust performance and serves as a valuable tool for clinicians to identify patients at high risk of 30-day mortality. © The Author(s) 2025.

引用

共 27 条

[1]

Grilz E., Et al., Relative risk of arterial and venous thromboembolism in persons with cancer vs. persons without cancer-a nationwide analysis, Eur. Heart J, 42, 23, pp. 2299-2307, (2021)

[2]

Mokart D., Et al., Acute pulmonary embolism in cancer patients admitted to intensive care unit: impact of anticoagulant treatment on 90-day mortality and risk factors, results of a multicentre retrospective study, Thromb. Res, 237, pp. 129-137, (2024)

[3]

Hisada Y., Mackman N., Cancer-associated pathways and biomarkers of venous thrombosis, Blood, 130, 13, pp. 1499-1506, (2017)

[4]

Lyman G.H., Et al., Morbidity, mortality and costs associated with venous thromboembolism in hospitalized patients with cancer, Thromb. Res, 164, pp. S112-S118, (2018)

[5]

Konstantinides S.V., Et al., 2019 ESC guidelines for the diagnosis and management of acute pulmonary embolism developed in collaboration with the European respiratory society (ERS), Eur. Heart J, 41, 4, pp. 543-603, (2020)

[6]

Khorana A.A., Et al., Thromboembolism in hospitalized neutropenic cancer patients, J. Clin. Oncol, 24, 3, pp. 484-490, (2006)

[7]

Zhao H., Et al., Prevalence and treatment of venous thromboembolism in patients with solid tumors, Exp. Ther. Med, 24, 6, (2022)

[8]

Key N.S., Et al., Venous thromboembolism prophylaxis and treatment in patients with cancer: ASCO guideline update, J. Clin. Oncol, 41, 16, pp. 3063-3071, (2023)

[9]

Sorensen H.T., Et al., Impact of venous thromboembolism on the mortality in patients with cancer: a population-based cohort study, Lancet Reg. Health Eur, 34, (2023)

[10]

Nishikawa T., Et al., Prognostic effect of incidental pulmonary embolism on Long-Term mortality in cancer patients, Circ. J, 88, 2, pp. 198-204, (2024)

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