A mortality risk prediction model for adult tetanus patients based on nomogram

HU Jianyang; ZHANG Lei; LIU Xiao; HUA Rong; YAN Xianliang; LIU Lin

doi:10.3969/j.issn.1007-8134.2025.02.012

Abstract：Objective To analyze the relationship between clinical characteristics,laboratory fingdings and treatment methods and prognosis of adult tetanus patients,a nomogram model was established to predict the mortality risk in adult tetanus patients,and its accuracy and clinical efficacy were evaluated.Methods Clinical data of 90 adult patients with tetanus from the Affiliated Hospital of Xuzhou Medical University from March 2011 to October 2023 were collected,including 30 cases in the death group and 60 cases in the survival group.The demographic data,laboratory tests,clinical manifestations and treatment methods were compared between the two groups.Univariate and multivariate regression analyses were performed to identify independent risk factors for predicting the risk of death in adult tetanus patients.R language software was used to visualize the logistic regression model,obtain the nomogram model,and evaluate the accuracy and clinical efficacy of the model.Results The mean age of 90 tetanus patients was(61.23±14.20)years.Multivariate Logistic regression analysis showed that age,Ablett grade,length of stay and mechanical ventilation were independent risk factors for mortality(P＜0.05,OR＞1).The concordant index for predicting the risk of death from tetanus in adults was 0.855 in the nomogram model based on the above independent risk factors.Bootstrap method was used to internally verify the nomogram model.The calibration curve showed that the average absolute error between the model's prediction of the risk of death and the actual risk of occurrence in adult tetanus patients was 0.029,the area under ROC curve was 0.855,with a diagnostic threshold was 0.339,and the corresponding sensitivity was 80 The specificity was 83.3％.Decision curve analysis shows that the performance and prediction effect of the model are good.Conclusions Age,Ablett grade,length of stay and mechanical ventilation are independent risk factors for mortality in adult tetanus patients.The nomogram model based on these risk factors can accurately predict the risk of death in adult tetanus patients,and has been effectively applied in clinical practice.The combination of age,Ablett grade,length of stay,and mechanical ventilation can better predict the prognosis of tetanus patients.