Analysis of Related Factors and Construction of A Nomogram Prediction Model for Acute Respiratory Distress Syndrome in Patients with Severe Trauma
JIANG Xiaoxiang
LIN Hairong
HE Fei
FU Shuiqin
CHEN A'zhen
Abstract：Objective To explore the related factors of acute respiratory distress syndrome(ARDS)in patients with severe trauma and to construct a nomogram prediction model.Methods A total of 212 patients with severe trauma admitted to The Second Affiliated Hospital of Xiamen Medical College from March 2023 to March 2025 were retrospectively selected.According to the occurrence of ARDS,they were divided into an ARDS group(83 cases)and a non-ARDS group(129 cases).General data,past medical history,injury characteristics,treatment conditions,and laboratory indicators were compared between the two groups.Multivariate Logistic regression analysis was used to identify independent risk factors for ARDS in severe trauma patients,and a nomogram prediction model was constructed based on these factors.The ROC curve was plotted to analyze the value of the nomogram prediction model in predicting ARDS in severe trauma patients.Results The ARDS group had higher proportions of Injury Severity Score≥25,pulmonary contusion,flail chest,admission hypoxemia,shock time≥4 h,laparotomy,aspiration of gastric contents,pulmonary infection,higher Abbreviated Injury Scale chest score,and higher serum tumor necrosis factor-α level at 24 h after admission compared to the non-ARDS group(P<0.05).Multivariate Logistic regression analysis showed that Injury Severity Score≥25,high Abbreviated Injury Scale chest score,pulmonary contusion,hypoxemia at admission,shock duration≥4 h,and high tumor necrosis factor-α level at 24 h after admission were independent risk factors for ARDS in severe trauma patients(OR=2.705,95%CI:1.631-4.485,P<0.01;OR=3.800,95%CI:2.310-6.252,P<0.01;OR=5.270,95%CI:3.038-9.141,P<0.01;OR=4.158,95%CI:2.483-6.962,P<0.01;OR=3.187,95%CI:2.058-4.934,P<0.01;OR=2.389,95%CI:1.433-3.985,P<0.01).ROC curve analysis showed that the nomogram prediction model had an AUC of 0.914,a sensitivity of 78.31%,and a specificity of 93.80%for predicting ARDS in severe trauma patients.Conclusion Injury Severity Score≥25,high Abbreviated Injury Scale chest score,pulmonary contusion,hypoxemia at admission,shock duration≥4 h,and high tumor necrosis factor-α level at 24 h after admission are independent risk factors for ARDS in severe trauma patients.The nomogram prediction model constructed based on these risk factors is an effective tool for predicting the occurrence of ARDS in severe trauma patients.
Keywords：severe traumaacute respiratory distress syndromerisk factornomogram
Publication Date：2026-01-20
Online Publishing Date：2026-01-24(First online date of this platform, not the publication date of the document)
Pages：6( 30-35 )