Establishment of a nomogram model to predict sepsis in patients with multiple trauma / 中华急诊医学杂志

ABSTRACT

Objective:To explore the risk factors of sepsis in patients with multiple trauma and construct a nomogram prediction model.Methods:The data of patients with multiple injuries admitted to the emergency intensive care unit (EICU) of the General Hospital of Ningxia Medical University from January 2021 to April 2022 were respectively collected. Inclusion criteria (1) meet the diagnostic criteria for multiple injuries; (2) the time from injury to admission ≤ 24 hours; (3) age>18 years old; (4) all examination or rescue measures were approved by the patient or the patient's family; (5) the patient's clinical data were complete. The patients were divided into sepsis group and non-sepsis group according to the definition of Sepsis 3.0 at the 28-day of EICU hospitalization. The receiver operating characteristic curve was drawn. Logistic regression analysis was applied to determine the independent predictors for sepsis, and the nomogram was constructed.Results:A total of 291 patients were included, including 102 in the sepsis group and 189 in the non-sepsis group. Multivariate logistic analysis revealed that age, acute physiology and chronic health status score (APACHE) Ⅱ, Glasgow Coma Scale (GCS), injury severity score (ISS), sequential organ failure assessment (SOFA) within 24 hours after admission, blood transfusion frequency, the application of norepinephrine, mechanical ventilation, pathogenic culture results, and history of diabetes were independent factors influencing the occurrence of sepsis. A nomogram model was constructed by combining these variables (AUC=0.913, 95% CI 0.847-0.942), and the model had a good fitting calibration curve. Conclusions:The nomogram constructed by age, APACHE-Ⅱ, GCS score, SOFA score, ISS score, number of blood transfusions, mechanical ventilation, norepinephrine drug use, pathogenic culture and diabetes has a good predictive value for sepsis in patients with multiple trauma in the later stage, which is worth promoting.