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A Nomogram Model for Predicting type-2 myocardial infarction Induced by Acute Upper Gastrointestinal Bleeding

Current Medical Science 2022年第2期42卷 317-326页

作者： Gui-jun JIANG Ru-kai GAO Min WANG Tu-xiu XIE Li-ying ZHAN Jie WEI Sheng-nan SUN Pei-yu JI Ding-yu TAN Jing-jun LYU Emergency Department Renmin Hospital of Wuhan UniversityWuhan430060China Department of Critical Care Medicine Renmin Hospital of Wuhan UniversityWuhan430060China Wuhan Britain-China School Wuhan430022China Medical College of Wuhan University of Science and Technology Wuhan430065China Department of General Practice Renmin Hospital of Wuhan UniversityWuhan430060China Emergency Department Qilu Hospital of Shandong University(Qingdao)Qingdao266000China Emergency Department Clinical Medical College of Yangzhou UniversityNorthern Jiangsu People’s HospitalYangzhou225001China

Objective To examine the independent risk factors of type-2 myocardial infarction(T2MI)elicited by acute upper gastrointestinal bleeding(AUGIB),and to establish a nomogram model for the prediction of AUGIB-induced *** A nomogram model was established on the basis of a retrospective study that involved 533 patients who suffered from AUGIB in the Department of Critical Care Medicine(CCM)or Emergency Intensive Care Unit(EICU)of Renmin Hospital of Wuhan University,Wuhan,China,from January 2017 to December *** predictive accuracy and discriminative power of the nomogram were initially evaluated by internal validation,which involved drawing the receiver operating characteristic(ROC)curve,calculating the area under the curve(AUC),plotting the calibration curve derived from 1000 resampled bootstrap data sets,and computing the root mean square error(RMSE).The predictive ability of the nomogram was further validated through the prospective and multicenter study conducted by the investigators,which enrolled 240 AUGIB patients[including 88 cases from Renmin Hospital of Wuhan University,73 cases from Qilu Hospital of Shandong University(Qingdao),and 79 cases from Northern Jiangsu People’s Hospital)],who were admitted to the Department of CCM or EICU,from February 2021 to July *** Among the 533 patients in the training cohort,78(14.6%)patients were assigned to the T2MI group and 455(85.4%)patients were assigned to the non-T2MI *** multivariate analysis revealed that age>65,hemorrhagic shock,cerebral stroke,heart failure,chronic kidney disease,increased blood urea nitrogen,decreased hematocrit,and elevated D-Dimer were independent risk factors for AUGIB-induced *** these factors were incorporated into the nomogram *** AUC for the nomogram for predicting T2MI was 0.829(95%CI,0.783-0.875)in the internal validation cohort and 0.848(95%CI,0.794-0.902)in the external validation *** calibration curve for the risk of T2MI exhibited good cons

关键词： acute upper gastrointestinal bleeding type-2 myocardial infarction nomogram prediction risk factors prognosis

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