Risk prediction model of in-hospital renal function deterioration in patients with acute heart failure with decreased ejection fraction
MAO Chenglu1, ZHAO Wenyan2, XU Miao3
1. Emergency Medicine Department, General Hospital of PLA Xinjiang Military Region, Urumqi 830000,China; 2. Drug and Instrument Supervision and Inspection Station of the Support Department of PLA Xinjiang Military Region, Urumqi 830000,China; 3. the First People’s Hospital of Urumqi,Urumqi 830000,China
Abstract：Objective To explore the factors influencing renal function deterioration (WRF) in patients with acute heart failure with decreased ejection fraction (AHFrEF), and to construct a risk prediction model. Methods A total of 418 patients with AHFrEF admitted to General Hospital of PLA Xinjiang Military Region from January 2020 to December 2023 were selected and divided into WRF group (98 cases) and non-WRF group (320 cases) according to whether hospital-acquired WRF occurred within 7 days of hospitalization. logistic regression was used to analyze the influencing factors of hospital-acquired WRF in AHFrEF patients, and a risk prediction model was established. Results Logistic regression analysis showed that age, diabetes, moist rales ≥1/3 lung field, edema of lower limbs, jugular vein filling ＞10 cm, creatinine, lactic acid, N-terminal pro-brain natriuretic peptide (NT-proBNP), troponin T and chloride ion levels were the risk factors of hospital-acquired WRF in AHFrEF patients, and hemoglobin was the protective factor (P<0.05). Bootstrap internal verification results show that the consistency index (C-index) was 0.864. The area under ROC curve was 0.853, 95%CI(0.812-0.947), the sensitivity was 87.25%, and the specificity was 78.34%. Hosmer-Lemeshow goodness-of-fit test showed that χ2=3.457, P=0.236. Conclusions Age, diabetes, volume overload, creatinine, lactic acid, NT-proBNP, troponin T and chloride ion levels are the risk factors for in-hospital WRF in patients with AHFrEF, and high hemoglobin is the protective factor. The nomogram model based on the above factors can accurately evaluate the risk of WRF in patients with AHFrEF.
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