A Prognostic Model for In-Hospital Mortality in Critically Ill Patients with Pneumonia

Abstract

Purpose To determine the utility of a novel serum biomarker for the outcome prediction of critically ill patients with pneumonia. Patients and Methods A retrospective analysis of critically ill patients was performed at an emergency department. The expression and prediction value of parameters were assessed. Binary logistic regression analysis was utilized to determine the indicators associated with in-hospital mortality of pneumonia patients. The Last Absolute Shrinkage and Selection Operator was used to further determine the independent predictors, which were validated by multiple logistic regression. The receiver operator characteristic curve was performed to assess their prediction values. A prognostic nomogram model was finally established for the outcome prediction for critically ill patients with pneumonia. Results Retinol-binding protein (RBP) was significantly reduced in non-survived and pneumonia patients. CURB-65 score, levels of RBP, and blood urea nitrogen (BUN) were associated with in-hospital mortality of critically ill patients with pneumonia. Their combination was determined to be an ideal prognostic predictor (area under the curve of 0.762) and further developed into a nomogram prediction model (c-index 0.764). Conclusion RBP is a novel in-hospital mortality predictor, which well supplements the CURB-65 score for critical pneumonia patients.

Development and validation of a predictive model for 30-day mortality in patients with severe community-acquired pneumonia in intensive care units

“…Characterized by raised BUN concentration, AKI was independently associated with the short-term mortality of CAP patients ( 30 , 31 ). Earlier studies indicated that individuals who did not survive CAP had elevated BUN levels ( 32 , 33 ). Consistent with previous studies on SCAP, this investigation revealed that the BUN level remained a significant predictive indicator of mortality, as demonstrated by multivariate analysis.…”

Development and validation of an in-hospital mortality risk prediction model for patients with severe community-acquired pneumonia in the intensive care unit

“…In previous studies on the prognosis of SCAP, either the study population was outside the ICU[8-10], the risk factors for mortality were not readily available clinically [9,10], no relevant predictive model was developed [11], or the model developed was not externally validated [10,12]. Generally, only a few comprehensive and accurate evaluation systems can adequately assess the prognosis of patients with SCAP admitted to the ICU at this stage.…”