PMID- 36172882
OWN - NLM
STAT- MEDLINE
DCOM- 20231225
LR  - 20231225
IS  - 1477-111X (Electronic)
IS  - 0267-6591 (Linking)
VI  - 39
IP  - 1
DP  - 2024 Jan
TI  - A nomogram to predict nosocomial infection in patients on venoarterial 
      extracorporeal membrane oxygenation after cardiac surgery.
PG  - 106-115
LID - 10.1177/02676591221130484 [doi]
AB  - INTRODUCTION: After cardiac surgery, patients on venoarterial extracorporeal 
      membrane oxygenation (VA-ECMO) have a higher risk of nosocomial infection in the 
      intensive care unit (ICU). We aimed to establish an intuitive nomogram to predict 
      the probability of nosocomial infection in patients on VA-ECMO after cardiac 
      surgery. METHODS: We included patients on VA-ECMO after cardiac surgery between 
      January 2011 and December 2020 at a single center. We developed a nomogram based 
      on independent predictors identified using univariate and multivariate logistic 
      regression analyses. We selected the optimal model and assessed its performance 
      through internal validation and decision-curve analyses. RESULTS: Overall, 503 
      patients were included; 363 and 140 patients were randomly divided into 
      development and validation sets, respectively. Independent predictors derived 
      from the development set to predict nosocomial infection included older age, 
      white blood cell (WBC) count abnormality, ECMO environment in the ICU, and 
      mechanical ventilation (MV) duration, which were entered into the model to create 
      the nomogram. The model showed good discrimination, with areas under the curve 
      (95% confidence interval) of 0.743 (0.692-0.794) in the development set and 0.732 
      (0.643-0.820) in the validation set. The optimal cutoff probability of the model 
      was 0.457 in the development set (sensitivity, 0.683; specificity, 0.719). The 
      model showed qualified calibration in both the development and validation sets 
      (Hosmer-Lemeshow test, p > .05). The threshold probabilities ranged from 0.20 to 
      0.70. CONCLUSIONS: For adult patients receiving VA-ECMO treatment after cardiac 
      surgery, a nomogram-monitoring tool could be used in clinical practice to 
      identify patients with high-risk nosocomial infections and provide an early 
      warning.
FAU - Li, Xiyuan
AU  - Li X
AD  - Center for Cardiac Intensive Care, Beijing Institute of Heart, Lung and Blood 
      Vessel Diseases, Beijing Anzhen Hospital, Capital Medical University, Beijing, 
      China.
AD  - Department of intensive care unit, Aviation General Hospital of China Medical 
      University, Beijing, China.
FAU - Wang, Liangshan
AU  - Wang L
AD  - Center for Cardiac Intensive Care, Beijing Institute of Heart, Lung and Blood 
      Vessel Diseases, Beijing Anzhen Hospital, Capital Medical University, Beijing, 
      China.
FAU - Li, Chenglong
AU  - Li C
AD  - Center for Cardiac Intensive Care, Beijing Institute of Heart, Lung and Blood 
      Vessel Diseases, Beijing Anzhen Hospital, Capital Medical University, Beijing, 
      China.
FAU - Wang, Xiaomeng
AU  - Wang X
AD  - Center for Cardiac Intensive Care, Beijing Institute of Heart, Lung and Blood 
      Vessel Diseases, Beijing Anzhen Hospital, Capital Medical University, Beijing, 
      China.
FAU - Hao, Xing
AU  - Hao X
AD  - Center for Cardiac Intensive Care, Beijing Institute of Heart, Lung and Blood 
      Vessel Diseases, Beijing Anzhen Hospital, Capital Medical University, Beijing, 
      China.
FAU - Du, Zhongtao
AU  - Du Z
AD  - Center for Cardiac Intensive Care, Beijing Institute of Heart, Lung and Blood 
      Vessel Diseases, Beijing Anzhen Hospital, Capital Medical University, Beijing, 
      China.
FAU - Xie, Haixiu
AU  - Xie H
AD  - Center for Cardiac Intensive Care, Beijing Institute of Heart, Lung and Blood 
      Vessel Diseases, Beijing Anzhen Hospital, Capital Medical University, Beijing, 
      China.
FAU - Yang, Feng
AU  - Yang F
AD  - Center for Cardiac Intensive Care, Beijing Institute of Heart, Lung and Blood 
      Vessel Diseases, Beijing Anzhen Hospital, Capital Medical University, Beijing, 
      China.
FAU - Wang, Hong
AU  - Wang H
AD  - Center for Cardiac Intensive Care, Beijing Institute of Heart, Lung and Blood 
      Vessel Diseases, Beijing Anzhen Hospital, Capital Medical University, Beijing, 
      China.
FAU - Hou, Xiaotong
AU  - Hou X
AD  - Center for Cardiac Intensive Care, Beijing Institute of Heart, Lung and Blood 
      Vessel Diseases, Beijing Anzhen Hospital, Capital Medical University, Beijing, 
      China.
LA  - eng
PT  - Journal Article
PT  - Randomized Controlled Trial
DEP - 20220929
PL  - England
TA  - Perfusion
JT  - Perfusion
JID - 8700166
SB  - IM
MH  - Adult
MH  - Humans
MH  - *Extracorporeal Membrane Oxygenation/adverse effects
MH  - Nomograms
MH  - *Cross Infection/etiology
MH  - *Cardiac Surgical Procedures/adverse effects
MH  - Risk Factors
MH  - Retrospective Studies
OTO - NOTNLM
OT  - cross-infection
OT  - extracorporeal membrane oxygenation
OT  - nomogram
OT  - predictive model
OT  - risk factors
COIS- Declaration of conflicting interestsThe author(s) declared no potential conflicts 
      of interest with respect to the research, authorship, and/or publication of this 
      article.
EDAT- 2022/09/30 06:00
MHDA- 2023/12/25 06:42
CRDT- 2022/09/29 05:12
PHST- 2023/12/25 06:42 [medline]
PHST- 2022/09/30 06:00 [pubmed]
PHST- 2022/09/29 05:12 [entrez]
AID - 10.1177/02676591221130484 [doi]
PST - ppublish
SO  - Perfusion. 2024 Jan;39(1):106-115. doi: 10.1177/02676591221130484. Epub 2022 Sep 
      29.