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A novel model for predicting prolonged stay of patients with type-2 diabetes mellitus: a 13-year (2010-2022) multicenter retrospective case-control study.
Tan, Juntao; Zhang, Zhengyu; He, Yuxin; Yu, Yue; Zheng, Jing; Liu, Yunyu; Gong, Jun; Li, Jianjun; Wu, Xin; Zhang, Shengying; Lin, Xiantian; Zhao, Yuxi; Wu, Xiaoxin; Tang, Songjia; Chen, Jingjing; Zhao, Wenlong.
Afiliação
  • Tan J; Operation Management Office, Affiliated Banan Hospital of Chongqing Medical University, Chongqing, 401320, China.
  • Zhang Z; Medical Records Department, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, 310003, Zhejiang, China.
  • He Y; Department of Medical Administration, Affiliated Banan Hospital of Chongqing Medical University, Chongqing, 401320, China.
  • Yu Y; Senior Bioinformatician Department of Quantitative Health Sciences Mayo Clinic, Rochester, MN, 55905, USA.
  • Zheng J; Operation Management Office, Affiliated Banan Hospital of Chongqing Medical University, Chongqing, 401320, China.
  • Liu Y; Medical Records Department, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, 400010, China.
  • Gong J; Department of Information Center, The University Town Hospital of Chongqing Medical University, Chongqing, 401331, China.
  • Li J; Department of Cardiothoracic Surgery, Affiliated Banan Hospital of Chongqing Medical University, Chongqing, 401320, China.
  • Wu X; Department of Gastrointestinal Surgery, The Third People's Hospital of Chongqing, Chongqing Medical University, Chongqing, 400038, China.
  • Zhang S; Department of Respiratory, Yinzhou Second Hospital, Ningbo, 315153, Zhejiang, China.
  • Lin X; State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, National Clinical Research Centre for Infectious Diseases, The First Affiliated Hospital, Zhejiang University School of Medicine, 79 Qing Chun Road, Hangzhou, 310003, Zhejiang, China.
  • Zhao Y; State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, National Clinical Research Centre for Infectious Diseases, The First Affiliated Hospital, Zhejiang University School of Medicine, 79 Qing Chun Road, Hangzhou, 310003, Zhejiang, China.
  • Wu X; State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, National Clinical Research Centre for Infectious Diseases, The First Affiliated Hospital, Zhejiang University School of Medicine, 79 Qing Chun Road, Hangzhou, 310003, Zhejiang, China. xiaoxinwu@zju.edu.cn.
  • Tang S; Plastic and Aesthetic Surgery Department, Affiliated Hangzhou First People's Hospital, Zhejiang University School of Medicine, Hangzhou, 310000, Zhejiang, China. tangsj@zju.edu.cn.
  • Chen J; Department of Digital Urban Governance, Zhejiang University City College, Hangzhou, 310015, Zhejiang, China. joyjchan@gmail.com.
  • Zhao W; College of Medical Informatics, Chongqing Medical University, Chongqing, 400016, China. cqzhaowl@163.com.
J Transl Med ; 21(1): 91, 2023 02 07.
Article em En | MEDLINE | ID: mdl-36750951
ABSTRACT

BACKGROUND:

Length of stay (LOS) is an important metric for evaluating the management of inpatients. This study aimed to explore the factors impacting the LOS of inpatients with type-2 diabetes mellitus (T2DM) and develop a predictive model for the early identification of inpatients with prolonged LOS.

METHODS:

A 13-year multicenter retrospective study was conducted on 83,776 patients with T2DM to develop and validate a clinical predictive tool for prolonged LOS. Least absolute shrinkage and selection operator regression model and multivariable logistic regression analysis were adopted to build the risk model for prolonged LOS, and a nomogram was taken to visualize the model. Furthermore, receiver operating characteristic curves, calibration curves, and decision curve analysis and clinical impact curves were used to respectively validate the discrimination, calibration, and clinical applicability of the model.

RESULTS:

The result showed that age, cerebral infarction, antihypertensive drug use, antiplatelet and anticoagulant use, past surgical history, past medical history, smoking, drinking, and neutrophil percentage-to-albumin ratio were closely related to the prolonged LOS. Area under the curve values of the nomogram in the training, internal validation, external validation set 1, and external validation set 2 were 0.803 (95% CI [confidence interval] 0.799-0.808), 0.794 (95% CI 0.788-0.800), 0.754 (95% CI 0.739-0.770), and 0.743 (95% CI 0.722-0.763), respectively. The calibration curves indicated that the nomogram had a strong calibration. Besides, decision curve analysis, and clinical impact curves exhibited that the nomogram had favorable clinical practical value. Besides, an online interface ( https//cytjt007.shinyapps.io/prolonged_los/ ) was developed to provide convenient access for users.

CONCLUSION:

In sum, the proposed model could predict the possible prolonged LOS of inpatients with T2DM and help the clinicians to improve efficiency in bed management.
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Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Diabetes Mellitus Tipo 2 Tipo de estudo: Etiology_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Limite: Humans Idioma: En Ano de publicação: 2023 Tipo de documento: Article

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Diabetes Mellitus Tipo 2 Tipo de estudo: Etiology_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Limite: Humans Idioma: En Ano de publicação: 2023 Tipo de documento: Article