PubTransformer

A site to transform Pubmed publications into these bibliographic reference formats: ADS, BibTeX, EndNote, ISI used by the Web of Knowledge, RIS, MEDLINE, Microsoft's Word 2007 XML.

Development and validation of a risk-prediction nomogram for in-hospital mortality in adults poisoned with drugs and nonpharmaceutical agents: An observational study.

Abstract Acute poisoning with drugs and nonpharmaceutical agents represents an important challenge in the emergency department (ED).The objective is to create and validate a risk-prediction nomogram for use in the ED to predict the risk of in-hospital mortality in adults from acute poisoning with drugs and nonpharmaceutical agents.This was a prospective cohort study involving adults with acute poisoning from drugs and nonpharmaceutical agents admitted to a tertiary referral center for toxicology between January and December 2015 (derivation cohort) and between January and June 2016 (validation cohort). We used a program to generate nomograms based on binary logistic regression predictive models. We included variables that had significant associations with death. Using regression coefficients, we calculated scores for each variable, and estimated the event probability. Model validation was performed using bootstrap to quantify our modeling strategy and using receiver operator characteristic (ROC) analysis. The nomogram was tested on a separate validation cohort using ROC analysis and goodness-of-fit tests.Data from 315 patients aged 18 to 91 years were analyzed (n = 180 in the derivation cohort; n = 135 in the validation cohort). In the final model, the following variables were significantly associated with mortality: age, laboratory test results (lactate, potassium, MB isoenzyme of creatine kinase), electrocardiogram parameters (QTc interval), and echocardiography findings (E wave velocity deceleration time). Sex was also included to use the same model for men and women. The resulting nomogram showed excellent survival/mortality discrimination (area under the curve [AUC] 0.976, 95% confidence interval [CI] 0.954-0.998, P < 0.0001 for the derivation cohort; AUC 0.957, 95% CI 0.892-1, P < 0.0001 for the validation cohort).This nomogram provides more precise, rapid, and simple risk-analysis information for individual patients acutely exposed to drugs and nonpharmaceutical agents, and accurately estimates the probability of in-hospital death, exclusively using the results of objective tests available in the ED.
PMID
Related Publications

Nomograms for risk of hepatocellular carcinoma in patients with chronic hepatitis B virus infection.

Prediction of 90-day mortality after radical cystectomy for bladder cancer in a prospective European multicenter cohort.

Hypoalbuminemia, Low Base Excess Values, and Tachypnea Predict 28-Day Mortality in Severe Sepsis and Septic Shock Patients in the Emergency Department.

An externally validated model for predicting long-term survival after exercise treadmill testing in patients with suspected coronary artery disease and a normal electrocardiogram.

Model to predict inpatient mortality from information gathered at presentation to an emergency department: The Triage Information Mortality Model (TIMM).

Authors

Mayor MeshTerms

Hospital Mortality

Nomograms

Keywords
Journal Title medicine
Publication Year Start




PMID- 28328838
OWN - NLM
STAT- MEDLINE
DA  - 20170322
DCOM- 20170410
LR  - 20170410
IS  - 1536-5964 (Electronic)
IS  - 0025-7974 (Linking)
VI  - 96
IP  - 12
DP  - 2017 Mar
TI  - Development and validation of a risk-prediction nomogram for in-hospital
      mortality in adults poisoned with drugs and nonpharmaceutical agents: An
      observational study.
PG  - e6404
LID - 10.1097/MD.0000000000006404 [doi]
AB  - Acute poisoning with drugs and nonpharmaceutical agents represents an important
      challenge in the emergency department (ED).The objective is to create and
      validate a risk-prediction nomogram for use in the ED to predict the risk of
      in-hospital mortality in adults from acute poisoning with drugs and
      nonpharmaceutical agents.This was a prospective cohort study involving adults
      with acute poisoning from drugs and nonpharmaceutical agents admitted to a
      tertiary referral center for toxicology between January and December 2015
      (derivation cohort) and between January and June 2016 (validation cohort). We
      used a program to generate nomograms based on binary logistic regression
      predictive models. We included variables that had significant associations with
      death. Using regression coefficients, we calculated scores for each variable, and
      estimated the event probability. Model validation was performed using bootstrap
      to quantify our modeling strategy and using receiver operator characteristic
      (ROC) analysis. The nomogram was tested on a separate validation cohort using ROC
      analysis and goodness-of-fit tests.Data from 315 patients aged 18 to 91 years
      were analyzed (n = 180 in the derivation cohort; n = 135 in the validation
      cohort). In the final model, the following variables were significantly
      associated with mortality: age, laboratory test results (lactate, potassium, MB
      isoenzyme of creatine kinase), electrocardiogram parameters (QTc interval), and
      echocardiography findings (E wave velocity deceleration time). Sex was also
      included to use the same model for men and women. The resulting nomogram showed
      excellent survival/mortality discrimination (area under the curve [AUC] 0.976,
      95% confidence interval [CI] 0.954-0.998, P &lt; 0.0001 for the derivation cohort;
      AUC 0.957, 95% CI 0.892-1, P &lt; 0.0001 for the validation cohort).This nomogram
      provides more precise, rapid, and simple risk-analysis information for individual
      patients acutely exposed to drugs and nonpharmaceutical agents, and accurately
      estimates the probability of in-hospital death, exclusively using the results of 
      objective tests available in the ED.
FAU - Lionte, Catalina
AU  - Lionte C
AD  - aInternal Medicine and Clinical Toxicology Department, "Grigore T. Popa"
      University of Medicine and Pharmacy bStatistics Department, FEAA, "Al. I. Cuza"
      University cRomanian Academy-"Gh. Zane" Institute for Economic and Social
      Research Teodor Codrescu No. 2, Iasi, Romania.
FAU - Sorodoc, Victorita
AU  - Sorodoc V
FAU - Jaba, Elisabeta
AU  - Jaba E
FAU - Botezat, Alina
AU  - Botezat A
LA  - eng
PT  - Journal Article
PT  - Observational Study
PL  - United States
TA  - Medicine (Baltimore)
JT  - Medicine
JID - 2985248R
SB  - AIM
SB  - IM
MH  - Adolescent
MH  - Adult
MH  - Age Factors
MH  - Aged
MH  - Aged, 80 and over
MH  - Blood Chemical Analysis
MH  - Electrocardiography
MH  - Emergency Service, Hospital/*statistics &amp; numerical data
MH  - Female
MH  - *Hospital Mortality
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - *Nomograms
MH  - Poisoning/*mortality
MH  - Probability
MH  - Prognosis
MH  - Prospective Studies
MH  - ROC Curve
MH  - Residence Characteristics
MH  - Risk Assessment
MH  - Sex Factors
MH  - Tertiary Care Centers
MH  - Young Adult
PMC - PMC5371475
EDAT- 2017/03/23 06:00
MHDA- 2017/04/11 06:00
CRDT- 2017/03/23 06:00
AID - 10.1097/MD.0000000000006404 [doi]
AID - 00005792-201703240-00041 [pii]
PST - ppublish
SO  - Medicine (Baltimore). 2017 Mar;96(12):e6404. doi: 10.1097/MD.0000000000006404.

<?xml version="1.0" encoding="UTF-8"?>
<b:Sources SelectedStyle="" xmlns:b="http://schemas.openxmlformats.org/officeDocument/2006/bibliography"  xmlns="http://schemas.openxmlformats.org/officeDocument/2006/bibliography" >
</b:Sources>