The risk factors of cardiogenic shock in patients with acute exacerbation of chronic heart failure and to construct and verify a Nomogram prediction model
Li Feifei
Peng Siqin
Chen Hong
Yu Hehua
Abstract：Objective To explore the risk factors of cardiogenic shock(CS)in patients with acute exacer-bation of chronic heart failure(ACHF),and to construct and verify a Nomogram prediction model.Methods A total of 216 ACHF patients admitted to Second Affiliated Hospital of Naval Medical University from June 2022 to June 2024 were retrospectively selected.According to the presence or absence of CS,the patients were divided into CS group(38 cases)and non-CS group(178 cases).Multivariate Logistic regression was used to analyze the risk factors of ACHF patients with CS,and a Nomogram prediction model was constructed based on the risk factors.Consistency index,calibration curve and decision curve analysis were used to evaluate the prediction accuracy,fit degree and clinical utility of the Nomogram prediction model.Results Multivariate Logistic regression analysis showed that atrial fibrillation,tricuspid regurgitation,deteriorating renal function and high level of N-terminal pro-brain natriuretic peptide(NT-proBNP)were risk factors for CS in ACHF patients(all P＜0.05).The Nomogram prediction model was constructed based on Logistic regression risk factors,and it was verified that the prediction model showed good discrimination(the area under the curve was 0.893,with 95％confidence interval of 0.844 to 0.931,P＜0.05)and calibration(C-index was 0.902,mean absolute error was 0.003).Decision curve analysis showed that the net benefit of the prediction model was high,suggesting high clinical applicability.Conclusion Deterioration of renal function,atrial fibrillation,tricuspid regurgitation and high level of NT-proBNP are risk factors for CS in ACHF patients.The prediction model based on the above risk factors has high prediction accuracy and clinical applicability.
Keywords：Acute exacerbation of chronic heart failureCardiogenic shockDeterioration of renal functionAtrial fibrillationTricuspid regurgitationN-terminal pro-brain natriuretic peptideNomogram prediction model
Publication Date：2025-04-18
Online Publishing Date：2026-09-14(First online date of this platform, not the publication date of the document)
Pages：6( 485-490 )