Construction of risk prediction nomogram model and prevention suggestions for elderly patients with acute exacerbation of COPD complicated with acute left ventricular failure

CHEN Yong; JI Manman

doi:10.12104/j.issn.1674-4748.2024.03.005

Abstract：Objective:To construct a risk prediction nomogram model for elderly patients with acute exacerbation of chronic obstructive pulmonary disease(COPD)complicated by acute left ventricular failure,and to provide prevention recommendations.Methods:The clinical data of 259 elderly patients with acute exacerbation of COPD admitted to the hospital from June 2020 to July 2022 were retrospectively analyzed.The patients were divided into concurrent group and non-complicated group according to whether they complicated with acute left heart failure.The multivariate logistic regression analysis method was used to analyze the risk factors of acute left heart failure during acute exacerbation of COPD in the elderly,and a risk prediction nomogram model was constructed.Results:Comorbid hypertension,diabetes,increased partial pressure of carbon dioxide,and right ventricular end-diastolic diameter were all risk factors for acute left heart failure in elderly patients with acute exacerbation of COPD(P＜0.05).Albumin,partial pressure of oxygen,and left ventricular inner diameter shortening rate were its protective factors(P＜0.05).A risk prediction nomogram model was constructed based on the above 7 influencing factors.The receiver operating characteristic curve showed that the area under the curve predicted by the model was 0.849(95％CI was 0.781,0.916),and the calibration curve fits well with the ideal curve.The Hosmer-Lemeshow test showed P=0.440.Conclusions:Integrating the influencing factors of acute exacerbation of COPD complicated with acute left heart failure in the elderly to construct a risk prediction nomogram model has good differentiation and accuracy,and has certain guiding value for clinical evaluation and intervention.