Development and validation of a prediction model of hospital mortality for patients with cardiac arrest survived 24 hours after cardiopulmonary resuscitation
ObjectiveResearch on predictive models for hospital mortality in patients who have survived 24 h following cardiopulmonary resuscitation (CPR) is limited. We aim to explore the factors associated with hospital mortality in these patients and develop a predictive model to aid clinical decision-making...
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Frontiers Media S.A.
2025-01-01
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| Series: | Frontiers in Cardiovascular Medicine |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fcvm.2025.1510710/full |
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| author | Renwei Zhang Zhenxing Liu Yumin Liu Li Peng |
| author_facet | Renwei Zhang Zhenxing Liu Yumin Liu Li Peng |
| author_sort | Renwei Zhang |
| collection | DOAJ |
| description | ObjectiveResearch on predictive models for hospital mortality in patients who have survived 24 h following cardiopulmonary resuscitation (CPR) is limited. We aim to explore the factors associated with hospital mortality in these patients and develop a predictive model to aid clinical decision-making and enhance the survival rates of patients post-resuscitation.MethodsWe sourced the data from a retrospective study within the Dryad dataset, dividing patients who suffered cardiac arrest following CPR into a training set and a validation set at a 7:3 ratio. We identified variables linked to hospital mortality in the training set using Least Absolute Shrinkage and Selection Operator (LASSO) regression, as well as univariate and multivariate logistic analyses. Utilizing these variables, we developed a prognostic nomogram for predicting mortality post-CPR. Calibration curves, the area under receiver operating curves (ROC), decision curve analysis (DCA), and clinical impact curve were used to assess the discriminability, accuracy, and clinical utility of the nomogram.ResultsThe study population comprised 374 patients, with 262 allocated to the training group and 112 to the validation group. Of these, 213 patients were dead in the hospital. Multivariate logistic analysis revealed age (OR 1.05, 95% CI: 1.03–1.08), witnessed arrest (OR 0.28, 95% CI: 0.11–0.73), time to return of spontaneous circulation (ROSC) (OR 1.05, 95% CI: 1.02–1.08), non-shockable rhythm (OR 3.41, 95% CI: 1.61–7.18), alkaline phosphatase (OR 1.01, 95% CI: 1–1.01), and sequential organ failure assessment (SOFA) (OR 1.27, 95% CI: 1.15–1.4) were independent risk factors for hospital mortality for patients who survived 24 h after CPR. ROC of the nomogram showed the AUC in the training and validation group was 0.827 and 0.817, respectively. Calibration curves, DCA, and clinical impact curve demonstrated the nomogram with good accuracy and clinical utility.ConclusionOur prediction model had accurate predictive value for hospital mortality in patients who survived 24 h after CPR, which will be beneficial for assisting in identifying high-risk patients and intervention. Further confirmation of the model's accuracy required external validation data. |
| format | Article |
| id | doaj-art-c0e59fd0ed394ec0a69093e4bcd9bfe8 |
| institution | Kabale University |
| issn | 2297-055X |
| language | English |
| publishDate | 2025-01-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Cardiovascular Medicine |
| spelling | doaj-art-c0e59fd0ed394ec0a69093e4bcd9bfe82025-01-27T06:40:42ZengFrontiers Media S.A.Frontiers in Cardiovascular Medicine2297-055X2025-01-011210.3389/fcvm.2025.15107101510710Development and validation of a prediction model of hospital mortality for patients with cardiac arrest survived 24 hours after cardiopulmonary resuscitationRenwei Zhang0Zhenxing Liu1Yumin Liu2Li Peng3Department of Neurology, Zhongnan Hospital of Wuhan University, Wuhan, ChinaDepartment of Neurology, Yiling Hospital of Yichang, Yichang, ChinaDepartment of Neurology, Zhongnan Hospital of Wuhan University, Wuhan, ChinaDepartment of Cardiology, Zhongnan Hospital of Wuhan University, Wuhan, ChinaObjectiveResearch on predictive models for hospital mortality in patients who have survived 24 h following cardiopulmonary resuscitation (CPR) is limited. We aim to explore the factors associated with hospital mortality in these patients and develop a predictive model to aid clinical decision-making and enhance the survival rates of patients post-resuscitation.MethodsWe sourced the data from a retrospective study within the Dryad dataset, dividing patients who suffered cardiac arrest following CPR into a training set and a validation set at a 7:3 ratio. We identified variables linked to hospital mortality in the training set using Least Absolute Shrinkage and Selection Operator (LASSO) regression, as well as univariate and multivariate logistic analyses. Utilizing these variables, we developed a prognostic nomogram for predicting mortality post-CPR. Calibration curves, the area under receiver operating curves (ROC), decision curve analysis (DCA), and clinical impact curve were used to assess the discriminability, accuracy, and clinical utility of the nomogram.ResultsThe study population comprised 374 patients, with 262 allocated to the training group and 112 to the validation group. Of these, 213 patients were dead in the hospital. Multivariate logistic analysis revealed age (OR 1.05, 95% CI: 1.03–1.08), witnessed arrest (OR 0.28, 95% CI: 0.11–0.73), time to return of spontaneous circulation (ROSC) (OR 1.05, 95% CI: 1.02–1.08), non-shockable rhythm (OR 3.41, 95% CI: 1.61–7.18), alkaline phosphatase (OR 1.01, 95% CI: 1–1.01), and sequential organ failure assessment (SOFA) (OR 1.27, 95% CI: 1.15–1.4) were independent risk factors for hospital mortality for patients who survived 24 h after CPR. ROC of the nomogram showed the AUC in the training and validation group was 0.827 and 0.817, respectively. Calibration curves, DCA, and clinical impact curve demonstrated the nomogram with good accuracy and clinical utility.ConclusionOur prediction model had accurate predictive value for hospital mortality in patients who survived 24 h after CPR, which will be beneficial for assisting in identifying high-risk patients and intervention. Further confirmation of the model's accuracy required external validation data.https://www.frontiersin.org/articles/10.3389/fcvm.2025.1510710/fullhospital mortalitynomogramcardiac arrestLASSOcardiopulmonary resuscitation |
| spellingShingle | Renwei Zhang Zhenxing Liu Yumin Liu Li Peng Development and validation of a prediction model of hospital mortality for patients with cardiac arrest survived 24 hours after cardiopulmonary resuscitation Frontiers in Cardiovascular Medicine hospital mortality nomogram cardiac arrest LASSO cardiopulmonary resuscitation |
| title | Development and validation of a prediction model of hospital mortality for patients with cardiac arrest survived 24 hours after cardiopulmonary resuscitation |
| title_full | Development and validation of a prediction model of hospital mortality for patients with cardiac arrest survived 24 hours after cardiopulmonary resuscitation |
| title_fullStr | Development and validation of a prediction model of hospital mortality for patients with cardiac arrest survived 24 hours after cardiopulmonary resuscitation |
| title_full_unstemmed | Development and validation of a prediction model of hospital mortality for patients with cardiac arrest survived 24 hours after cardiopulmonary resuscitation |
| title_short | Development and validation of a prediction model of hospital mortality for patients with cardiac arrest survived 24 hours after cardiopulmonary resuscitation |
| title_sort | development and validation of a prediction model of hospital mortality for patients with cardiac arrest survived 24 hours after cardiopulmonary resuscitation |
| topic | hospital mortality nomogram cardiac arrest LASSO cardiopulmonary resuscitation |
| url | https://www.frontiersin.org/articles/10.3389/fcvm.2025.1510710/full |
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