Construction and validation of a predictive model of mortality of tuberculosis-destroyed lung patients requiring mechanical ventilation: A single-center retrospective case-control study

Abstract

AbstractBackgroundThe mortality rate for intensive care unit (ICU) tuberculosis-destroyed lung (TDL) patients requiring mechanical ventilation remains high.MethodsWe conducted a retrospective analysis of adult TDL patients requiring mechanical ventilation who were admitted to the ICU of a tertiary infectious disease hospital in Chengdu, Sichuan Province, China from January 2019 to March 2023. Univariate and multivariate COX regression analyses were conducted to determine independent patient prognostic risk factors that were used to construct a predictive model of patient mortality.ResultsFor the 331 study subjects, the median age was 63.0 (50.0-71.0) years, 262 (79.2%) were males and the mortality rate was 48.64% (161/331). Training and validation data sets were obtained from 245 and 86 patients, respectively. Analysis of the training data set revealed that a body mass index (BMI) of<18.5kg/m2, blood urea nitrogen level of ≥7.14mmol/L and septic shock were independent risk factors for increased mortality of TDL patients requiring mechanical ventilation. These variables were then used to construct a risk-based model for predicting patient mortality. Area under the curve,sensitivity and specificity values obtained using the model for the training data set were 0.808, 79.17% and 68.80%, respectively, and corresponding values obtained using the validation data set were 0.876, 95.12% and 62.22%. respectively. Results of concurrent correction curve and decision curve analyses verified the model possessed high predictiveability.ConclusionsThis model may facilitate early identification and classification-based clinical management of TDL patients requiring mechanical ventilation who are at high risk of death.