射血分数降低的急性心力衰竭患者院内肾功能恶化的风险预测模型

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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.

Key words： decreased ejection fraction acute heart failure deterioration of renal function risk prediction model

Received: 13 June 2024

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	MAO Chenglu
	ZHAO Wenyan
	XU Miao

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MAO Chenglu,ZHAO Wenyan,XU Miao. Risk prediction model of in-hospital renal function deterioration in patients with acute heart failure with decreased ejection fraction[J]. Med. J. Chin. Peop. Armed Poli. Forc., 2024, 35(12): 1077-1082.

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https://journal08.magtechjournal.com/Jwk_wjyx/EN/ OR https://journal08.magtechjournal.com/Jwk_wjyx/EN/Y2024/V35/I12/1077

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