Construction of a predictive nomogram for stroke-associated pneumonia in patients with intracerebral hemorrhage using clinical data and serum markers and its validation
ZHAO Lei
XUE Jian
ZHANG Wenliang
Abstract：Objective To investigate the risk factors for stroke-associated pneumonia(SAP)in patients with intracerebral hemorrhage(ICH)and to develop a nomogram to predict them.Methods A survey was conducted involving 321 cases of ICH patients with SAP.They were categorized into the SAP group and the control group based on the presence or absence of SAP.Clinical data,neutrophil-to-lymphocyte ratio(NLR)and platelet-to-lymphocyte ratio(PLR)levels were collected.With SAP occurrence as the dependent variable,independent risk factors for SAP in ICH patients were identified using Lasso regression and Logistic regression.A nomogram was constructed using the R package,and validated for its performance.Results Among the 321 ICH patients,57 developed SAP.Lasso regression and Logistic regression identified that age,underlying lung disease,diabetes,dysphagia,NLR,PLR and tracheal intubation were independent risk factors for SAP in ICH patients.A nomogram was constructed based on these factors.The C-index value of the nomogram was 0.867(95％CI:0.856-0.945),demonstrating an excellent discriminative ability.The area under the curve(AUC)was 0.815(95％CI:0.854-0.945),indicating a high level of model accuracy.The calibration curve demonstrated that the nomogram possessed a reasonably reliable predictive capability.Clinical decision curve analysis yielded a higher net benefit of the nomogram when the MCI probability threshold was above 11％and below 85％.Conclusion The nomogram for predicting SAP in ICH patients exhibits outstanding discrimination and precision.
Keywords：intracerebral hemorrhagestroke-associated pneumonianomogramprediction model
Publication Date：2024-11-10
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：5( 3263-3267 )