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Article(id=1190669168887350263, tenantId=1146029695717560320, journalId=1189873630562394117, issueId=1190669163988398295, articleNumber=null, orderNo=null, doi=10.11855/j.issn.0577-7402.1759.2025.0305, pmid=null, cstr=null, oa=null, hot=null, price=null, onlineType=0, articleFormat=0, articleType=null, articleTypeStr=research-article, receivedDate=1730736000000, receivedDateStr=2024-11-05, revisedDate=null, revisedDateStr=null, acceptedDate=1740067200000, acceptedDateStr=2025-02-21, onlineDate=1761807251426, onlineDateStr=2025-10-30, pubDate=1745769600000, pubDateStr=2025-04-28, doiRegisterDate=null, doiRegisterDateStr=null, onlineIssueDate=1761807251426, onlineIssueDateStr=2025-10-30, onlineJustAcceptDate=null, onlineJustAcceptDateStr=null, onlineFirstDate=null, onlineFirstDateStr=null, sourceXml=null, magXml=null, createTime=1761807251426, creator=13701087609, updateTime=1761807251426, updator=13701087609, issue=Issue{id=1190669163988398295, tenantId=1146029695717560320, journalId=1189873630562394117, year='2025', volume='50', issue='4', pageStart='367', pageEnd='503', issueExtLink='null', onlineDate='null', pubDate='null', beforeIssueId=null, nextIssueId=null, price=null, status=1, issueComplete=1, articleOrder=1, issueType=-1, specialIssue=0, createTime=1761807250258, creator=13701087609, updateTime=1761807667423, updator=13701087609, preIssue=null, nextIssue=null, ext={EN=IssueExt(id=1190670913772339410, tenantId=1146029695717560320, journalId=1189873630562394117, issueId=1190669163988398295, language=EN, specialIssueTitle=, coverIllustrator=null, specialIssueEditor=, specialIssueAbout=), CN=IssueExt(id=1190670913772339411, tenantId=1146029695717560320, journalId=1189873630562394117, issueId=1190669163988398295, language=CN, specialIssueTitle=, coverIllustrator=null, specialIssueEditor=, specialIssueAbout=)}, issueFiles=null}, startPage=400, endPage=408, ext={EN=ArticleExt(id=1190669169126425593, articleId=1190669168887350263, tenantId=1146029695717560320, journalId=1189873630562394117, language=EN, title=Construction and evaluation of a medium- and long-term prognosis model for severe community-acquired pneumonia based on MIMIC-Ⅳ database, columnId=1190310109000602400, journalTitle=Medical Journal of Chinese People’s Liberation Army, columnName=Clinical Research, runingTitle=null, highlight=null, articleAbstract=

Objective To explore the risk factors for medium- and long-term mortality in patients with severe community-acquired pneumonia (SCAP) based on the Medical Information Mart for Intensive Care Ⅳ (MIMIC-Ⅳ), construct a prognostic model and evaluate its predictive efficacy. Methods In this retrospective cohort study, 1943 SCAP patients from the U.S. MIMIC-Ⅳ database (2008-2019) were randomly divided into training (n=1363) and validation (n=580) sets (7:3 ratio). Primary and secondary endpoints were 1-year and 30-/90-day all-cause mortality, respectively. Prognostic factors were selected using LASSO regression and multivariable Cox proportional hazards modeling, and a visual nomogram model was built. Model performance was assessed via C-index, receiver operator characteristic (ROC) curves, and calibration curves, and compared with the CURB-65 score. Risk stratification was validated using Kaplan-Meier analysis. Results The 30-day, 90-day, and 1-year all-cause mortality rates for SCAP patients were 25.9%, 34.5%, and 42.6%, respectively. Seven independent risk factors were identified: age (HR=1.037), heart rate (HR=1.007), red blood cell distribution width (RDW, HR=1.092), Acute Physiology Score Ⅲ (APS-Ⅲ, HR=1.013), cerebrovascular disease (HR=1.453), liver disease (HR=1.272), and malignancy (HR=2.007). Based on these factors, Cox regression model was constructed and nomogram was drawn, C-indices of training set and validation set were 0.710 and 0.688, respectively. For 1-year mortality prediction, the model achieved superior area under the ROC curve (AUC) values (training set: 0.768; validation set: 0.738) compared with CURB-65 score (training set: 0.648; validation set: 0.616). Kaplan-Meier survival analysis revealed significantly worse survival in high-risk group than low-risk group (P<0.0001). Conclusions Age, heart rate, RDW, APS-Ⅲ, cerebrovascular disease, liver disease, and malignant tumor were medium- and long-term mortality risk factors in SCAP patients. The prognostic model constructed based on these factors has high predictive power and provides an important clinical diagnosis and treatment reference.

, correspAuthors=Bin-Xiao Su, authorNote=null, correspAuthorsNote=
E-mail:
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目的 基于美国重症监护医学信息数据库(MIMIC-Ⅳ)探究重症社区获得性肺炎(SCAP)患者的中长期死亡危险因素，构建预后模型并评估其预测效能。方法 采用回顾性队列研究设计，纳入2008-2019年美国MIMIC-Ⅳ数据库中1943例SCAP患者，按7:3的比例随机分为训练集(1363例)与验证集(580例)。主要研究终点为1年全因死亡，次要终点包括30 d及90 d全因死亡。通过LASSO回归结合多因素Cox比例风险模型筛选独立预后因素，构建可视化列线图模型。采用一致性指数(C指数)、受试者操作特征(ROC)曲线及校准曲线评估模型效能，并与传统的CURB-65评分进行比较。采用Kaplan-Meier生存分析验证风险分层能力。结果 SCAP患者的30 d、90 d及1年全因死亡率分别为25.9%、34.5%、42.6%。研究确定了7项独立危险因素：年龄(HR=1.037)、心率(HR=1.007)、红细胞分布宽度(RDW，HR=1.092)、急性生理学评分Ⅲ(APS-Ⅲ，HR=1.013)、脑血管疾病(HR=1.453)、肝脏疾病(HR=1.272)和恶性肿瘤(HR=2.007)。据此构建Cox回归模型并绘制列线图，模型在训练集和验证集的C指数分别为0.710和0.688，ROC曲线下面积(AUC)显示其预测效能(1年AUC：训练集0.768，验证集0.738)优于CURB-65评分(1年AUC：训练集0.648，验证集0.616)。Kaplan-Meier分析显示高风险组生存率明显低于低风险组(P<0.0001)。结论 年龄、心率、RDW、APS-Ⅲ评分、脑血管疾病、肝脏疾病、恶性肿瘤是SCAP患者中长期死亡的独立危险因素。基于这些因素构建的预后模型具备较高的预测效能，可为临床诊疗提供有效的重要参考。

, correspAuthors=苏斌虓, authorNote=null, correspAuthorsNote=
苏斌虓，E-mail：
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邓南利，硕士研究生，主要从事重症社区获得性肺炎预后方面的临床研究

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邓南利，硕士研究生，主要从事重症社区获得性肺炎预后方面的临床研究

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tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1190669168887350263, language=CN, orderNo=4, keyword=LASSO回归)], refs=[Reference(id=1190669366137078545, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1190669168887350263, doi=null, pmid=null, pmcid=null, year=2016, volume=39, issue=4, pageStart=253, pageEnd=279, url=null, language=null, rfNumber=[1], rfOrder=0, authorNames=中华医学会呼吸病学分会, journalName=中华结核和呼吸杂志, refType=null, unstructuredReference=中华医学会呼吸病学分会. 中国成人社区获得性肺炎诊断和治疗指南(2016年版)[J]. 中华结核和呼吸杂志, 2016, 39(4): 253-279., articleTitle=中国成人社区获得性肺炎诊断和治疗指南(2016年版), refAbstract=null), Reference(id=1190669366199993106, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1190669168887350263, doi=null, pmid=null, pmcid=null, year=2024, volume=49, issue=11, pageStart=1295, pageEnd=1301, url=null, language=null, rfNumber=[2], rfOrder=1, authorNames=郭鑫龙, 赵志伟, 庞桂芬, journalName=解放军医学杂志, refType=null, unstructuredReference=郭鑫龙, 赵志伟, 庞桂芬, 等. 红细胞体积分布宽度变异系数和血清IL-11、IL-31在间质性肺疾病诊断中的应用价值[J]. 解放军医学杂志, 2024, 49(11): 1295-1301., articleTitle=红细胞体积分布宽度变异系数和血清IL-11、IL-31在间质性肺疾病诊断中的应用价值, refAbstract=null), Reference(id=1190669366254519059, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1190669168887350263, doi=null, pmid=null, pmcid=null, year=2022, volume=50, issue=7, pageStart=1063, pageEnd=1071, url=null, language=null, rfNumber=[3], rfOrder=2, authorNames=Haessler S, Guo N, Deshpande A, journalName=Crit Care Med, refType=null, unstructuredReference=Haessler S, Guo N, Deshpande A, et al. Etiology, treatments, and outcomes of patients with severe community-acquired pneumonia in a large U.S. sample[J]. Crit Care Med, 2022, 50(7): 1063-1071., articleTitle=Etiology, treatments, and outcomes of patients with severe community-acquired pneumonia in a large U.S. sample, refAbstract=null), Reference(id=1190669366338405140, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1190669168887350263, doi=null, pmid=null, pmcid=null, year=2022, volume=48, issue=8, pageStart=1009, pageEnd=1023, url=null, language=null, rfNumber=[4], rfOrder=3, authorNames=Umberto Meduri G, Shih MC, Bridges L, journalName=Intensive Care Med, refType=null, unstructuredReference=Umberto Meduri G, Shih MC, Bridges L, et al. Low-dose methylprednisolone treatment in critically ill patients with severe community-acquired pneumonia[J]. Intensive Care Med, 2022, 48(8): 1009-1023., articleTitle=Low-dose methylprednisolone treatment in critically ill patients with severe community-acquired pneumonia, refAbstract=null), Reference(id=1190669366405514005, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1190669168887350263, doi=null, pmid=null, pmcid=null, year=2018, volume=13, issue=1, pageStart=null, pageEnd=null, url=null, language=null, rfNumber=[5], rfOrder=4, authorNames=Ferrer M, Travierso C, Cilloniz C, journalName=PLoS One, refType=null, unstructuredReference=Ferrer M, Travierso C, Cilloniz C, et al. Severe community-acquired pneumonia: characteristics and prognostic factors in ventilated and non-ventilated patients[J]. PLoS One, 2018, 13(1): e0191721., articleTitle=Severe community-acquired pneumonia: characteristics and prognostic factors in ventilated and non-ventilated patients, refAbstract=null), Reference(id=1190669366468428566, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1190669168887350263, doi=null, pmid=null, pmcid=null, year=2006, volume=27, issue=1, pageStart=151, pageEnd=157, url=null, language=null, rfNumber=[6], rfOrder=5, authorNames=Capelastegui A, España PP, Quintana JM, journalName=Eur Respir J, refType=null, unstructuredReference=Capelastegui A, España PP, Quintana JM, et al. Validation of a predictive rule for the management of community-acquired pneumonia[J]. Eur Respir J, 2006, 27(1): 151-157., articleTitle=Validation of a predictive rule for the management of community-acquired pneumonia, refAbstract=null), Reference(id=1190669366535537431, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1190669168887350263, doi=null, pmid=null, pmcid=null, year=2008, volume=47, issue=null, pageStart=S133, pageEnd=S139, url=null, language=null, rfNumber=[7], rfOrder=6, authorNames=Aujesky D, Fine MJ, journalName=Clin Infect Dis, refType=null, unstructuredReference=Aujesky D, Fine MJ. The pneumonia severity index: a decade after the initial derivation and validation[J]. Clin Infect Dis, 2008, 47(Suppl 3): S133-S139., articleTitle=The pneumonia severity index: a decade after the initial derivation and validation, refAbstract=null), Reference(id=1190669366590063384, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1190669168887350263, doi=null, pmid=null, pmcid=null, year=2003, volume=58, issue=5, pageStart=377, pageEnd=382, url=null, language=null, rfNumber=[8], rfOrder=7, authorNames=Lim WS, van der Eerden MM, Laing R, journalName=Thorax, refType=null, unstructuredReference=Lim WS, van der Eerden MM, Laing R, et al. Defining community acquired pneumonia severity on presentation to hospital: an international derivation and validation study[J]. Thorax, 2003, 58(5): 377-382., articleTitle=Defining community acquired pneumonia severity on presentation to hospital: an international derivation and validation study, refAbstract=null), Reference(id=1190669366661366553, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1190669168887350263, doi=null, pmid=null, pmcid=null, year=2019, volume=6, issue=1, pageStart=null, pageEnd=null, url=null, language=null, rfNumber=[9], rfOrder=8, authorNames=Grudzinska FS, Aldridge K, Hughes S, journalName=BMJ Open Respir Res, refType=null, unstructuredReference=Grudzinska FS, Aldridge K, Hughes S, et al. Early identification of severe community-acquired pneumonia: a retrospective observational study[J]. BMJ Open Respir Res, 2019, 6(1): e000438., articleTitle=Early identification of severe community-acquired pneumonia: a retrospective observational study, refAbstract=null), Reference(id=1190669366720086810, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1190669168887350263, doi=null, pmid=null, pmcid=null, year=2023, volume=10, issue=1, pageStart=1, pageEnd=null, url=null, language=null, rfNumber=[10], rfOrder=9, authorNames=Johnson AEW, Bulgarelli L, Shen L, journalName=Sci Data, refType=null, unstructuredReference=Johnson AEW, Bulgarelli L, Shen L, et al. MIMIC-Ⅳ, a freely accessible electronic health record dataset[J]. Sci Data, 2023, 10(1): 1., articleTitle=MIMIC-Ⅳ, a freely accessible electronic health record dataset, refAbstract=null), Reference(id=1190669366783001371, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1190669168887350263, doi=null, pmid=null, pmcid=null, year=2019, volume=200, issue=7, pageStart=e45, pageEnd=e67, url=null, language=null, rfNumber=[11], rfOrder=10, authorNames=Metlay JP, Waterer GW, Long AC, journalName=Am J Respir Crit Care Med, refType=null, unstructuredReference=Metlay JP, Waterer GW, Long AC, et al. Diagnosis and treatment of adults with community-acquired pneumonia.:An official clinical practice guideline of the American thoracic society and infectious diseases society of America[J]. Am J Respir Crit Care Med, 2019, 200(7): e45-e67., articleTitle=Diagnosis and treatment of adults with community-acquired pneumonia.:An official clinical practice guideline of the American thoracic society and infectious diseases society of America, refAbstract=null), Reference(id=1190669366837527324, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1190669168887350263, doi=null, pmid=null, pmcid=null, year=2020, volume=158, issue=3, pageStart=1008, pageEnd=1016, url=null, language=null, rfNumber=[12], rfOrder=11, authorNames=Cavallazzi R, Furmanek S, Arnold FW, journalName=Chest, refType=null, unstructuredReference=Cavallazzi R, Furmanek S, Arnold FW, et al. The burden of community-acquired pneumonia requiring admission to ICU in the United States[J]. Chest, 2020, 158(3): 1008-1016., articleTitle=The burden of community-acquired pneumonia requiring admission to ICU in the United States, refAbstract=null), Reference(id=1190669366896247581, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1190669168887350263, doi=null, pmid=null, pmcid=null, year=2009, volume=14, issue=3, pageStart=327, pageEnd=335, url=null, language=null, rfNumber=[13], rfOrder=12, authorNames=Niederman MS, journalName=Respirology, refType=null, unstructuredReference=Niederman MS. Making sense of scoring systems in community acquired pneumonia[J]. Respirology, 2009, 14(3): 327-335., articleTitle=Making sense of scoring systems in community acquired pneumonia, refAbstract=null), Reference(id=1190669366950773534, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1190669168887350263, doi=null, pmid=null, pmcid=null, year=2024, volume=24, issue=1, pageStart=334, pageEnd=null, url=null, language=null, rfNumber=[14], rfOrder=13, authorNames=Tuta-Quintero E, Bastidas AR, Guerrón-Gómez G, journalName=BMC Pulm Med, refType=null, unstructuredReference=Tuta-Quintero E, Bastidas AR, Guerrón-Gómez G, et al. Performance of risk scores in predicting mortality at 3, 6, and 12 months in patients diagnosed with community-acquired pneumonia[J]. BMC Pulm Med, 2024, 24(1): 334., articleTitle=Performance of risk scores in predicting mortality at 3, 6, and 12 months in patients diagnosed with community-acquired pneumonia, refAbstract=null), Reference(id=1190669367017882399, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1190669168887350263, doi=null, pmid=null, pmcid=null, year=2013, volume=24, issue=2, pageStart=e15, pageEnd=e16, url=null, language=null, rfNumber=[15], rfOrder=14, authorNames=Lippi G, Dipalo M, Teti L, journalName=Eur J Intern Med, refType=null, unstructuredReference=Lippi G, Dipalo M, Teti L, et al. Relationship between red blood cell distribution width and prognostic biomarkers in patients admitted to the emergency department with acute infections[J]. Eur J Intern Med, 2013, 24(2): e15-e16., articleTitle=Relationship between red blood cell distribution width and prognostic biomarkers in patients admitted to the emergency department with acute infections, refAbstract=null), Reference(id=1190669367072408352, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1190669168887350263, doi=null, pmid=null, pmcid=null, year=2015, volume=52, issue=2, pageStart=86, pageEnd=105, url=null, language=null, rfNumber=[16], rfOrder=15, authorNames=Salvagno GL, Sanchis-Gomar F, Picanza A, journalName=Crit Rev Clin Lab Sci, refType=null, unstructuredReference=Salvagno GL, Sanchis-Gomar F, Picanza A, et al. Red blood cell distribution width: a simple parameter with multiple clinical applications[J]. Crit Rev Clin Lab Sci, 2015, 52(2): 86-105., articleTitle=Red blood cell distribution width: a simple parameter with multiple clinical applications, refAbstract=null), Reference(id=1190669367139517217, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1190669168887350263, doi=null, pmid=null, pmcid=null, year=2014, volume=14, issue=null, pageStart=129, pageEnd=null, url=null, language=null, rfNumber=[17], rfOrder=16, authorNames=Braun E, Kheir J, Mashiach T, journalName=BMC Infect Dis, refType=null, unstructuredReference=Braun E, Kheir J, Mashiach T, et al. Is elevated red cell distribution width a prognostic predictor in adult patients with community acquired pneumonia?[J]. BMC Infect Dis, 2014, 14: 129., articleTitle=Is elevated red cell distribution width a prognostic predictor in adult patients with community acquired pneumonia?, refAbstract=null), Reference(id=1190669367210820386, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1190669168887350263, doi=null, pmid=null, pmcid=null, year=2011, volume=15, issue=4, pageStart=null, pageEnd=null, url=null, language=null, rfNumber=[18], rfOrder=17, authorNames=Braun E, Domany E, Kenig Y, journalName=Crit Care, refType=null, unstructuredReference=Braun E, Domany E, Kenig Y, et al. Elevated red cell distribution width predicts poor outcome in young patients with community acquired pneumonia[J]. Crit Care, 2011, 15(4): R194., articleTitle=Elevated red cell distribution width predicts poor outcome in young patients with community acquired pneumonia, refAbstract=null), Reference(id=1190669367261152035, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1190669168887350263, doi=null, pmid=null, pmcid=null, year=2014, volume=68, issue=6, pageStart=534, pageEnd=541, url=null, language=null, rfNumber=[19], rfOrder=18, authorNames=Adamuz J, Viasus D, Jiménez-Martínez E, journalName=J Infect, refType=null, unstructuredReference=Adamuz J, Viasus D, Jiménez-Martínez E, et al. Incidence, timing and risk factors associated with 1-year mortality after hospitalization for community-acquired pneumonia[J]. J Infect, 2014, 68(6): 534-541., articleTitle=Incidence, timing and risk factors associated with 1-year mortality after hospitalization for community-acquired pneumonia, refAbstract=null), Reference(id=1190669367315677988, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1190669168887350263, doi=null, pmid=null, pmcid=null, year=2021, volume=25, issue=1, pageStart=24, pageEnd=null, url=null, language=null, rfNumber=[20], rfOrder=19, authorNames=Dupuis C, Sabra A, Patrier J, journalName=Crit Care, refType=null, unstructuredReference=Dupuis C, Sabra A, Patrier J, et al. Burden of pneumococcal pneumonia requiring ICU admission in France: 1-year prognosis, resources use, and costs[J]. Crit Care, 2021, 25(1): 24., articleTitle=Burden of pneumococcal pneumonia requiring ICU admission in France: 1-year prognosis, resources use, and costs, refAbstract=null), Reference(id=1190669367366009637, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1190669168887350263, doi=null, pmid=null, pmcid=null, year=2001, volume=344, issue=9, pageStart=665, pageEnd=671, url=null, language=null, rfNumber=[21], rfOrder=20, authorNames=Marik PE, journalName=N Engl J Med, refType=null, unstructuredReference=Marik PE. Aspiration pneumonitis and aspiration pneumonia[J]. N Engl J Med, 2001, 344(9): 665-671., articleTitle=Aspiration pneumonitis and aspiration pneumonia, refAbstract=null), Reference(id=1190669367420535590, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1190669168887350263, doi=null, pmid=null, pmcid=null, year=2022, volume=42, issue=2, pageStart=86, pageEnd=96, url=null, language=null, rfNumber=[22], rfOrder=21, authorNames=佘君, 丁建文, 申捷, journalName=国际呼吸杂志, refType=null, unstructuredReference=佘君, 丁建文, 申捷. 成人吸入性肺炎诊断和治疗专家建议[J]. 国际呼吸杂志, 2022, 42(2): 86-96., articleTitle=成人吸入性肺炎诊断和治疗专家建议, refAbstract=null), Reference(id=1190669367483450151, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1190669168887350263, doi=null, pmid=null, pmcid=null, year=2021, volume=185, issue=null, pageStart=106485, pageEnd=null, url=null, language=null, rfNumber=[23], rfOrder=22, authorNames=Almirall J, Boixeda R, de la Torre MC, journalName=Respir Med, refType=null, unstructuredReference=Almirall J, Boixeda R, de la Torre MC, et al. Aspiration pneumonia: a renewed perspective and practical approach[J]. 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A. 回归系数路径图；B. 交叉验证曲线

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SCAP. 重症社区获得性肺炎；APS-Ⅲ. 急性生理学评分Ⅲ

, figureFileSmall=7qrYE18M+qVH1GamYJYPYA==, figureFileBig=m2+FyFc9qpQD6D3mJDewwQ==, tableContent=null), ArticleFig(id=1190669365025587971, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1190669168887350263, language=EN, label=Fig.3, caption=ROC curve of the model in the training set (A) and validation set (B) for predicting the risk death at 30-day, 90-day and 1-year in SCAP patients, figureFileSmall=XZO1CvxRFXEckuB658n2Vw==, figureFileBig=eEE4wKE+92o6GAqfwcvbJw==, tableContent=null), ArticleFig(id=1190669365113668356, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1190669168887350263, language=CN, label=图3, caption=训练集(A)与验证集(B)中模型预测SCAP患者30 d、90 d、1年死亡风险的ROC曲线

SCAP. 重症社区获得性肺炎；ROC. 受试者操作特征；AUC. 曲线下面积

, figureFileSmall=XZO1CvxRFXEckuB658n2Vw==, figureFileBig=eEE4wKE+92o6GAqfwcvbJw==, tableContent=null), ArticleFig(id=1190669365201748741, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1190669168887350263, language=EN, label=Fig.4, caption=ROC curve of the CURB-65 score in the training set (A) and validation set (B) for predicting the risk death at 30-day, 90-day and 1-year in SCAP patients, figureFileSmall=V3tfuYln2piOC2ePMhjIEg==, figureFileBig=4OHpRsnSPMDgO0eUbnEbww==, tableContent=null), ArticleFig(id=1190669365273051910, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1190669168887350263, language=CN, label=图4, caption=训练集(A)与验证集(B)中CURB-65评分预测SCAP患者30 d、90 d、1年死亡风险的ROC曲线

SCAP. 重症社区获得性肺炎；ROC. 受试者操作特征

, figureFileSmall=V3tfuYln2piOC2ePMhjIEg==, figureFileBig=4OHpRsnSPMDgO0eUbnEbww==, tableContent=null), ArticleFig(id=1190669365377909511, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1190669168887350263, language=EN, label=Fig.5, caption=Calibration curves of the model in the training set (A) and validation set (B) for predicting the risk death at 30-day, 90-day and 1-year in SCAP patients, figureFileSmall=7slkRx8N8AlX2gPPQHPsXQ==, figureFileBig=eB93HL+YxcMCfzm1BK8urw==, tableContent=null), ArticleFig(id=1190669365453406984, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1190669168887350263, language=CN, label=图5, caption=训练集(A)与验证集(B)中模型预测SCAP患者30 d、90 d、1年死亡风险的校准曲线

SCAP. 重症社区获得性肺炎

, figureFileSmall=7slkRx8N8AlX2gPPQHPsXQ==, figureFileBig=eB93HL+YxcMCfzm1BK8urw==, tableContent=null), ArticleFig(id=1190669365520515849, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1190669168887350263, language=EN, label=Fig.6, caption=Risk-stratified survival curves of SCAP patients in the training set (A) and validation set (B), figureFileSmall=I3Um7MJlGot7PsSmtCe+dg==, figureFileBig=szyXLFz9sTTfUhKics1vBQ==, tableContent=null), ArticleFig(id=1190669365591819018, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1190669168887350263, language=CN, label=图6, caption=训练集(A)及验证集(B)中SCAP患者风险分层生存曲线

SCAP. 重症社区获得性肺炎

, figureFileSmall=I3Um7MJlGot7PsSmtCe+dg==, figureFileBig=szyXLFz9sTTfUhKics1vBQ==, tableContent=null), ArticleFig(id=1190669365654733579, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1190669168887350263, language=EN, label=Tab.1, caption=

Comparison of baseline clinical characteristics among different groups of SCAP patients

, figureFileSmall=null, figureFileBig=null, tableContent=
临床特征总人群(n=1943)训练集(n=1363)验证集(n=580)χ²/ZP
人口学特征
年龄[岁, M(Q1, Q3)]66.0(54.0, 77.0)66.5(53.0, 77.0)65.0(54.0, 78.0)-0.3610.718
男性[例(%)]1128(58.1)779(57.2)349(60.1)1.2640.261
种族[例(%)]0.1870.822
白种人1102(56.7)774(56.8)328(56.5)
黑种人172(8.6)117(8.6)55(9.5)
其他669(34.4)472(34.6)197(34.1)
生命体征[M(Q1, Q3)]
体温(℃)37.0(36.7, 37.5)37.0(36.7, 37.5)37.1(36.6, 37.5)-0.3020.762
心率(次/min)88.0(76.0, 101.0)88.0(76.0, 101.0)88.0(76.0, 102.0)-0.5910.555
呼吸频率(次/min)21.0(18.0, 24.0)21.0(18.0, 24.0)21.0(18.0, 24.0)-0.3820.705
平均动脉压(mmHg)76.0(71.0, 82.0)76.0(71.0, 82.0)76.0(71.0, 82.0)-0.2770.791
SpO2(%)92.0(89.0, 95.0)92.0(89.0, 95.0)92.0(89.0, 95.0)-0.5810.559
实验室指标[M(Q1, Q3)]
Hb(g/L)10.1(8.5, 11.7)10.0(8.4, 11.6)10.3(8.7, 11.7)-1.6760.097
HCT(%)30.7(26.0, 35.6)30.5(25.9, 35.5)30.9(26.3, 35.9)-1.4550.147
PLT(×109/L)166.0(113.0, 229.0)167.0(113.0, 229.0)163.0(113.0, 229.0)-0.1510.886
WBC(×109/L)15.4(10.9, 20.8)15.5(11.0, 21.1)14.9(10.2, 20.2)-1.9840.048
NEUT(×109/L)11.2(7.3, 15.9)11.3(7.3, 16.2)10.7(7.1, 15.2)-1.8200.069
LYMPH(×109/L)1.1(0.7, 1.7)1.7(0.7, 1.6)1.1(0.7, 1.7)-0.5170.609
RDW(%)14.6(13.6, 16.1)14.6(13.6, 16.2)14.6(13.6, 15.9)-1.2640.209
血糖(mmol/L)9.2(7.3, 12.4)9.2(7.3, 12.6)9.2(7.4, 12.0)-0.6010.548
肌酐(μmol/L)114.9(79.6, 181.1)110.5(79.6, 176.8)114.9(79.6, 185.6)-0.2010.844
血尿素氮(mmol/L)9.28(6.07, 15.36)9.28(6.07, 15.36)9.28(6.07, 15.00)-0.1020.920
钙离子(mmol/L)7.8(7.3, 8.3)7.8(7.2, 8.3)7.8(7.3, 8.4)-1.3140.191
氯离子(mmol/L)107.0(102.0, 111.0)107.0(103.0, 111.0)107.0(102.0, 111.0)-0.5800.560
钠离子(mmol/L)137.0(134.0, 140.0)137.0(134.0, 140.0)138.0(134.0, 141.0)-1.0840.279
钾离子( mmol/L)4.60(4.10, 5.20)4.60(4.10, 5.20)4.50(4.10, 5.20)-0.1910.849
乳酸(mmol/L)2.10(1.30, 3.70)2.10(1.40, 3.80)2.00(1.30, 3.60)-1.3110.190
INR1.30(1.20, 1.70)1.30(1.20, 1.70)1.30(1.20, 1.70)-0.3130.752
PT(s)14.6(12.9, 18.4)14.6(12.9, 18.4)14.5(13.0, 18.3)-0.2410.809
PTT(s)33.5(28.3, 46.1)33.9(28.3, 47.7)32.9(28.3, 43.4)-1.4570.148
pH7.30(7.21, 7.38)7.29(7.21, 7.38)7.30(7.21, 7.38)-0.8450.400
PaO2(mmHg)74.0(59.0, 99.0)74.0(59.0, 99.0)75.0(59.0, 99.0)-0.2880.774
PaCO2(mmHg)47.0(40.0, 58.0)47.0(41.0, 58.0)47.0(40.0, 58.0)-0.7240.470
氧合指数(mmHg)148.0(91.8, 243.0)146.0(91.7, 237.0)150.0(92.5, 253.0)-0.8870.377
阴离子间隙(mmol/L)17.0(14.0, 20.0)17.0(14.0, 20.0)17.0(14.0, 20.0)-0.8520.397
碳酸氢盐(mmol/L)24.0(21.0, 27.0)24.0(21.0, 27.0)24.0(21.0, 27.0)-0.2240.823
疾病严重程度
急性肾损伤[例(%)]0.0820.962
Ⅰ期569(29.3)397(29.1)172(29.6)
Ⅱ期218(11.2)150(11.0)68(11.7)
Ⅲ期251(12.9)177(13.0)74(12.7)
SOFA评分[分, M(Q1, Q3)]3.0(2.0, 5.0)3.0(2.0, 5.0)3.0(2.0, 5.0)-0.7010.488
GCS评分[分, M(Q1, Q3)]9.0(5.0, 13.0)9.0(5.0, 13.0)9.0(6.0, 13.0)-0.0240.983
CURB-65评分[分, M(Q1, Q3)]3.0(2.0, 4.0)3.0(2.0, 4.0)3.0(2.0, 4.0)-0.2620.793
SAPS-Ⅱ评分[分, M(Q1, Q3)]44.0(34.5, 54.0)44.0(35.0, 54.0)43.0(34.0, 54.0)-0.5940.553
APS-Ⅲ评分[分, M(Q1, Q3)]69.0(51.0, 91.0)69.0(51.0, 91.0)69.0(52.0, 90.0)-0.7150.481
脓毒症[例(%)]1907(98.1)1335(98.0)572(98.5)0.2270.642
并发症[例(%)]
心肌梗死346(17.8)236(17.3)110(18.8)0.5640.455
充血性心力衰竭681(35.0)468(34.3)213(36.5)0.7650.387
慢性阻塞性肺疾病675(34.7)470(34.5)205(35.3)0.0850.782
痴呆76(3.9)49(3.6)27(4.6)0.9470.335
脑血管疾病357(18.4)249(18.3)108(18.6)0.0180.924
糖尿病572(29.4)398(29.2)174(29.9)0.0780.789
肾脏疾病392(20.2)283(20.8)109(18.8)0.9120.341
肝脏疾病358(18.4)260(19.1)98(16.9)1.2010.274
恶性肿瘤209(10.8)144(10.6)65(11.2)0.0940.749
治疗措施[例(%)]
有创机械通气1666(85.7)1172(86.0)494(85.0)0.2710.603
连续肾脏替代治疗88(4.5)55(4.0)33(5.7)2.1710.140
血管升压药治疗88(4.5)55(4.0)33(5.7)2.1710.140
病原体[例(%)]
金黄色葡萄球菌264(13.6)183(13.4)81(13.9)0.0540.822
MRSA107(5.5)77(5.7)30(5.2)0.1120.745
铜绿假单胞菌67(3.5)40(2.9)27(4.6)3.1130.079
肺炎克雷伯菌49(2.5)35(2.6)14(2.4)0.0120.962
住院时间[d, M(Q1, Q3)]
总住院时间15.0(10.0, 24.0)16.0(10.0, 24.0)15.0(10.0, 23.0)-2.1350.222
ICU住院时间9.0(6.0, 15.0)9.0(6.0, 15.0)9.0(5.0, 15.0)-0.6340.529
结局[例(%)]
30 d死亡504(25.9)353(25.9)151(26.0)0.0010.990
90 d死亡670(34.5)455(33.4)215(37.0)2.1820.140
1年死亡828(42.6)584(42.8)244(42.1)0.3340.564
), ArticleFig(id=1190669365747008268, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1190669168887350263, language=CN, label=表1, caption=

不同分组的SCAP患者基线临床特征比较

, figureFileSmall=null, figureFileBig=null, tableContent=
临床特征总人群(n=1943)训练集(n=1363)验证集(n=580)χ²/ZP
人口学特征
年龄[岁, M(Q1, Q3)]66.0(54.0, 77.0)66.5(53.0, 77.0)65.0(54.0, 78.0)-0.3610.718
男性[例(%)]1128(58.1)779(57.2)349(60.1)1.2640.261
种族[例(%)]0.1870.822
白种人1102(56.7)774(56.8)328(56.5)
黑种人172(8.6)117(8.6)55(9.5)
其他669(34.4)472(34.6)197(34.1)
生命体征[M(Q1, Q3)]
体温(℃)37.0(36.7, 37.5)37.0(36.7, 37.5)37.1(36.6, 37.5)-0.3020.762
心率(次/min)88.0(76.0, 101.0)88.0(76.0, 101.0)88.0(76.0, 102.0)-0.5910.555
呼吸频率(次/min)21.0(18.0, 24.0)21.0(18.0, 24.0)21.0(18.0, 24.0)-0.3820.705
平均动脉压(mmHg)76.0(71.0, 82.0)76.0(71.0, 82.0)76.0(71.0, 82.0)-0.2770.791
SpO2(%)92.0(89.0, 95.0)92.0(89.0, 95.0)92.0(89.0, 95.0)-0.5810.559
实验室指标[M(Q1, Q3)]
Hb(g/L)10.1(8.5, 11.7)10.0(8.4, 11.6)10.3(8.7, 11.7)-1.6760.097
HCT(%)30.7(26.0, 35.6)30.5(25.9, 35.5)30.9(26.3, 35.9)-1.4550.147
PLT(×109/L)166.0(113.0, 229.0)167.0(113.0, 229.0)163.0(113.0, 229.0)-0.1510.886
WBC(×109/L)15.4(10.9, 20.8)15.5(11.0, 21.1)14.9(10.2, 20.2)-1.9840.048
NEUT(×109/L)11.2(7.3, 15.9)11.3(7.3, 16.2)10.7(7.1, 15.2)-1.8200.069
LYMPH(×109/L)1.1(0.7, 1.7)1.7(0.7, 1.6)1.1(0.7, 1.7)-0.5170.609
RDW(%)14.6(13.6, 16.1)14.6(13.6, 16.2)14.6(13.6, 15.9)-1.2640.209
血糖(mmol/L)9.2(7.3, 12.4)9.2(7.3, 12.6)9.2(7.4, 12.0)-0.6010.548
肌酐(μmol/L)114.9(79.6, 181.1)110.5(79.6, 176.8)114.9(79.6, 185.6)-0.2010.844
血尿素氮(mmol/L)9.28(6.07, 15.36)9.28(6.07, 15.36)9.28(6.07, 15.00)-0.1020.920
钙离子(mmol/L)7.8(7.3, 8.3)7.8(7.2, 8.3)7.8(7.3, 8.4)-1.3140.191
氯离子(mmol/L)107.0(102.0, 111.0)107.0(103.0, 111.0)107.0(102.0, 111.0)-0.5800.560
钠离子(mmol/L)137.0(134.0, 140.0)137.0(134.0, 140.0)138.0(134.0, 141.0)-1.0840.279
钾离子( mmol/L)4.60(4.10, 5.20)4.60(4.10, 5.20)4.50(4.10, 5.20)-0.1910.849
乳酸(mmol/L)2.10(1.30, 3.70)2.10(1.40, 3.80)2.00(1.30, 3.60)-1.3110.190
INR1.30(1.20, 1.70)1.30(1.20, 1.70)1.30(1.20, 1.70)-0.3130.752
PT(s)14.6(12.9, 18.4)14.6(12.9, 18.4)14.5(13.0, 18.3)-0.2410.809
PTT(s)33.5(28.3, 46.1)33.9(28.3, 47.7)32.9(28.3, 43.4)-1.4570.148
pH7.30(7.21, 7.38)7.29(7.21, 7.38)7.30(7.21, 7.38)-0.8450.400
PaO2(mmHg)74.0(59.0, 99.0)74.0(59.0, 99.0)75.0(59.0, 99.0)-0.2880.774
PaCO2(mmHg)47.0(40.0, 58.0)47.0(41.0, 58.0)47.0(40.0, 58.0)-0.7240.470
氧合指数(mmHg)148.0(91.8, 243.0)146.0(91.7, 237.0)150.0(92.5, 253.0)-0.8870.377
阴离子间隙(mmol/L)17.0(14.0, 20.0)17.0(14.0, 20.0)17.0(14.0, 20.0)-0.8520.397
碳酸氢盐(mmol/L)24.0(21.0, 27.0)24.0(21.0, 27.0)24.0(21.0, 27.0)-0.2240.823
疾病严重程度
急性肾损伤[例(%)]0.0820.962
Ⅰ期569(29.3)397(29.1)172(29.6)
Ⅱ期218(11.2)150(11.0)68(11.7)
Ⅲ期251(12.9)177(13.0)74(12.7)
SOFA评分[分, M(Q1, Q3)]3.0(2.0, 5.0)3.0(2.0, 5.0)3.0(2.0, 5.0)-0.7010.488
GCS评分[分, M(Q1, Q3)]9.0(5.0, 13.0)9.0(5.0, 13.0)9.0(6.0, 13.0)-0.0240.983
CURB-65评分[分, M(Q1, Q3)]3.0(2.0, 4.0)3.0(2.0, 4.0)3.0(2.0, 4.0)-0.2620.793
SAPS-Ⅱ评分[分, M(Q1, Q3)]44.0(34.5, 54.0)44.0(35.0, 54.0)43.0(34.0, 54.0)-0.5940.553
APS-Ⅲ评分[分, M(Q1, Q3)]69.0(51.0, 91.0)69.0(51.0, 91.0)69.0(52.0, 90.0)-0.7150.481
脓毒症[例(%)]1907(98.1)1335(98.0)572(98.5)0.2270.642
并发症[例(%)]
心肌梗死346(17.8)236(17.3)110(18.8)0.5640.455
充血性心力衰竭681(35.0)468(34.3)213(36.5)0.7650.387
慢性阻塞性肺疾病675(34.7)470(34.5)205(35.3)0.0850.782
痴呆76(3.9)49(3.6)27(4.6)0.9470.335
脑血管疾病357(18.4)249(18.3)108(18.6)0.0180.924
糖尿病572(29.4)398(29.2)174(29.9)0.0780.789
肾脏疾病392(20.2)283(20.8)109(18.8)0.9120.341
肝脏疾病358(18.4)260(19.1)98(16.9)1.2010.274
恶性肿瘤209(10.8)144(10.6)65(11.2)0.0940.749
治疗措施[例(%)]
有创机械通气1666(85.7)1172(86.0)494(85.0)0.2710.603
连续肾脏替代治疗88(4.5)55(4.0)33(5.7)2.1710.140
血管升压药治疗88(4.5)55(4.0)33(5.7)2.1710.140
病原体[例(%)]
金黄色葡萄球菌264(13.6)183(13.4)81(13.9)0.0540.822
MRSA107(5.5)77(5.7)30(5.2)0.1120.745
铜绿假单胞菌67(3.5)40(2.9)27(4.6)3.1130.079
肺炎克雷伯菌49(2.5)35(2.6)14(2.4)0.0120.962
住院时间[d, M(Q1, Q3)]
总住院时间15.0(10.0, 24.0)16.0(10.0, 24.0)15.0(10.0, 23.0)-2.1350.222
ICU住院时间9.0(6.0, 15.0)9.0(6.0, 15.0)9.0(5.0, 15.0)-0.6340.529
结局[例(%)]
30 d死亡504(25.9)353(25.9)151(26.0)0.0010.990
90 d死亡670(34.5)455(33.4)215(37.0)2.1820.140
1年死亡828(42.6)584(42.8)244(42.1)0.3340.564
), ArticleFig(id=1190669365822505741, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1190669168887350263, language=EN, label=Tab.2, caption=

Multivariate Cox regression analysis of risk factors for 1-year mortality in SCAP patients

, figureFileSmall=null, figureFileBig=null, tableContent=
变量βWald χ²HR(95%CI)P
年龄0.036128.4291.037(1.030~1.043)<0.001
心率0.0077.3691.007(1.002~1.012)0.007
RDW0.08826.8861.092(1.056~1.129)<0.001
APS-Ⅲ评分0.01261.0301.013(1.009~1.016)<0.001
脑血管疾病0.37412.5151.453(1.181~1.787)<0.001
肝脏疾病0.2414.5471.272(1.020~1.587)0.033
恶性肿瘤0.69639.1812.007(1.614~2.496)<0.001
), ArticleFig(id=1190669365893808910, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1190669168887350263, language=CN, label=表2, caption=

SCAP患者1年死亡危险因素的多因素Cox回归分析

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变量βWald χ²HR(95%CI)P
年龄0.036128.4291.037(1.030~1.043)<0.001
心率0.0077.3691.007(1.002~1.012)0.007
RDW0.08826.8861.092(1.056~1.129)<0.001
APS-Ⅲ评分0.01261.0301.013(1.009~1.016)<0.001
脑血管疾病0.37412.5151.453(1.181~1.787)<0.001
肝脏疾病0.2414.5471.272(1.020~1.587)0.033
恶性肿瘤0.69639.1812.007(1.614~2.496)<0.001
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基于MIMIC-Ⅳ数据库的重症社区获得性肺炎中长期预后模型的构建与评估
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邓南利 1, 2 , 刘仁怀 1 , 柴薪 1 , 张西京 1 , 苏斌虓 1, *
解放军医学杂志 | 临床研究 2025,50(4): 400-408
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解放军医学杂志 | 临床研究 2025, 50(4): 400-408
基于MIMIC-Ⅳ数据库的重症社区获得性肺炎中长期预后模型的构建与评估
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邓南利1, 2, 刘仁怀1, 柴薪1, 张西京1, 苏斌虓1, *
作者信息
  • 1空军军医大学西京医院重症医学科，陕西西安 710032
  • 2空军军医大学西京医院麻醉与围术期医学科，陕西西安 710032

    • 邓南利，硕士研究生，主要从事重症社区获得性肺炎预后方面的临床研究

通讯作者:

苏斌虓，E-mail：
Construction and evaluation of a medium- and long-term prognosis model for severe community-acquired pneumonia based on MIMIC-Ⅳ database
Nan-Li Deng1, 2, Ren-Huai Liu1, Xin Chai1, Xi-Jing Zhang1, Bin-Xiao Su1, *
Affiliations
  • 1Department of Intensive Care Medicine, Xijing Hospital, Air Force Medical University, Xi'an, Shaanxi 710032, China
  • 2Department of Anesthesiology and Perioperative Medicine, Xijing Hospital, Air Force Medical University, Xi'an, Shaanxi 710032, China
出版时间: 2025-04-28 doi: 10.11855/j.issn.0577-7402.1759.2025.0305
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摘要
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目的 基于美国重症监护医学信息数据库(MIMIC-Ⅳ)探究重症社区获得性肺炎(SCAP)患者的中长期死亡危险因素，构建预后模型并评估其预测效能。方法 采用回顾性队列研究设计，纳入2008-2019年美国MIMIC-Ⅳ数据库中1943例SCAP患者，按7:3的比例随机分为训练集(1363例)与验证集(580例)。主要研究终点为1年全因死亡，次要终点包括30 d及90 d全因死亡。通过LASSO回归结合多因素Cox比例风险模型筛选独立预后因素，构建可视化列线图模型。采用一致性指数(C指数)、受试者操作特征(ROC)曲线及校准曲线评估模型效能，并与传统的CURB-65评分进行比较。采用Kaplan-Meier生存分析验证风险分层能力。结果 SCAP患者的30 d、90 d及1年全因死亡率分别为25.9%、34.5%、42.6%。研究确定了7项独立危险因素：年龄(HR=1.037)、心率(HR=1.007)、红细胞分布宽度(RDW，HR=1.092)、急性生理学评分Ⅲ(APS-Ⅲ，HR=1.013)、脑血管疾病(HR=1.453)、肝脏疾病(HR=1.272)和恶性肿瘤(HR=2.007)。据此构建Cox回归模型并绘制列线图，模型在训练集和验证集的C指数分别为0.710和0.688，ROC曲线下面积(AUC)显示其预测效能(1年AUC：训练集0.768，验证集0.738)优于CURB-65评分(1年AUC：训练集0.648，验证集0.616)。Kaplan-Meier分析显示高风险组生存率明显低于低风险组(P<0.0001)。结论 年龄、心率、RDW、APS-Ⅲ评分、脑血管疾病、肝脏疾病、恶性肿瘤是SCAP患者中长期死亡的独立危险因素。基于这些因素构建的预后模型具备较高的预测效能，可为临床诊疗提供有效的重要参考。

重症社区获得性肺炎  /  MIMIC-Ⅳ数据库  /  预后模型  /  LASSO回归

Objective To explore the risk factors for medium- and long-term mortality in patients with severe community-acquired pneumonia (SCAP) based on the Medical Information Mart for Intensive Care Ⅳ (MIMIC-Ⅳ), construct a prognostic model and evaluate its predictive efficacy. Methods In this retrospective cohort study, 1943 SCAP patients from the U.S. MIMIC-Ⅳ database (2008-2019) were randomly divided into training (n=1363) and validation (n=580) sets (7:3 ratio). Primary and secondary endpoints were 1-year and 30-/90-day all-cause mortality, respectively. Prognostic factors were selected using LASSO regression and multivariable Cox proportional hazards modeling, and a visual nomogram model was built. Model performance was assessed via C-index, receiver operator characteristic (ROC) curves, and calibration curves, and compared with the CURB-65 score. Risk stratification was validated using Kaplan-Meier analysis. Results The 30-day, 90-day, and 1-year all-cause mortality rates for SCAP patients were 25.9%, 34.5%, and 42.6%, respectively. Seven independent risk factors were identified: age (HR=1.037), heart rate (HR=1.007), red blood cell distribution width (RDW, HR=1.092), Acute Physiology Score Ⅲ (APS-Ⅲ, HR=1.013), cerebrovascular disease (HR=1.453), liver disease (HR=1.272), and malignancy (HR=2.007). Based on these factors, Cox regression model was constructed and nomogram was drawn, C-indices of training set and validation set were 0.710 and 0.688, respectively. For 1-year mortality prediction, the model achieved superior area under the ROC curve (AUC) values (training set: 0.768; validation set: 0.738) compared with CURB-65 score (training set: 0.648; validation set: 0.616). Kaplan-Meier survival analysis revealed significantly worse survival in high-risk group than low-risk group (P<0.0001). Conclusions Age, heart rate, RDW, APS-Ⅲ, cerebrovascular disease, liver disease, and malignant tumor were medium- and long-term mortality risk factors in SCAP patients. The prognostic model constructed based on these factors has high predictive power and provides an important clinical diagnosis and treatment reference.

severe community-acquired pneumonia  /  MIMIC-Ⅳ database  /  prognostic model  /  LASSO regression
邓南利, 刘仁怀, 柴薪, 张西京, 苏斌虓. 基于MIMIC-Ⅳ数据库的重症社区获得性肺炎中长期预后模型的构建与评估. 解放军医学杂志, 2025 , 50 (4) : 400 -408 . DOI: 10.11855/j.issn.0577-7402.1759.2025.0305
Nan-Li Deng, Ren-Huai Liu, Xin Chai, Xi-Jing Zhang, Bin-Xiao Su. Construction and evaluation of a medium- and long-term prognosis model for severe community-acquired pneumonia based on MIMIC-Ⅳ database[J]. Medical Journal of Chinese People’s Liberation Army, 2025 , 50 (4) : 400 -408 . DOI: 10.11855/j.issn.0577-7402.1759.2025.0305
正文
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社区获得性肺炎(community-acquired pneumonia，CAP)是常见的呼吸道疾病[1]，其重症类型为重症社区获得性肺炎(severe community-acquired pneumonia，SCAP)，因常并发休克或需机械通气而需收治于重症监护室(intensive care unit，ICU)[2]。流行病学研究显示，14.1%的CAP患者进展为SCAP，其住院死亡率可达22.0%[3]，且中远期预后堪忧(180 d及1年死亡率分别为21%与32%)[4]，而接受有创机械通气者30 d死亡率高达51.33%[5]，造成了沉重的公共卫生负担。目前临床常用的SCAP预后评估工具包括肺炎严重程度指数(pneumonia severity index，PSI)和CURB-65评分[包括：C(confusion，意识障碍)、U(urea，尿素氮)、R(respiratory rate，呼吸频率)、B(blood pressure，收缩压)以及65(指年龄≥65岁)][6]。PSI虽具有高敏感性和特异性[7]，但由于包含20个变量，操作复杂且部分参数临床获取困难，限制了其应用。CURB-65评分系统使用简便，常用于判断CAP患者是否需要住院治疗[8]，也能有效预测SCAP患者的短期死亡率[9]。然而，现有评分体系主要关注SCAP的短期死亡风险，缺乏稳定有效的中长期评估工具。本研究基于美国重症监护医学信息数据库(Medical Information Mart for Intensive Care Ⅳ，MIMIC-Ⅳ)构建SCAP患者中长期死亡风险预测模型并进行验证，旨在为SCAP患者提供有效的中长期死亡风险评估工具，进而对出院后的高危患者进行精准监测与随访，最终实现降低再住院率及远期死亡率的目标。
1 资料与方法
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1.1 数据来源
收集2008-2019年MIMIC-Ⅳ数据库中的美国马萨诸塞州波士顿贝斯以色列女执事医疗中心的1943例SCAP患者资料进行回顾性分析，将所有患者按7:3的比例随机分为训练集(n=1363)与验证集(n=580)。该数据库由麻省理工学院计算生理学实验室维护[10]。研究者已通过培训并获得访问权限(证书编号：61602980)，该数据库的使用经伦理豁免，符合《赫尔辛基宣言》要求。
1.2 研究人群的纳入、排除标准
纳入标准：(1)年龄>18岁，符合国际疾病分类第9/10版肺炎诊断编码，且入院48 h内接受抗生素治疗。(2)同时符合SCAP诊断标准，依据美国胸科学会/美国传染病学会(ATS/IDSA)指南[11]，诊断SCAP需满足一项主要标准(呼吸衰竭需机械通气或感染性休克需血管加压药物)，或至少3项次要标准(呼吸频率≥30次/min，氧合指数≤250 mmHg，多肺叶浸润，意识或定向障碍，血尿素氮≥7.14 mmol/L，白细胞计数<4×109/L，血小板计数<100×109/L，核心体温<36 ℃，低血压需要液体复苏)。排除标准：(1)非首次入住ICU或ICU住院时间<3 d；(2)妊娠或哺乳期女性；(3)数据缺失>20%。
1.3 数据收集
采用Navicat Premium 16.0.11提取入ICU首日数据：(1)人口学资料，年龄、性别、种族；(2)生命体征，体温、心率、呼吸频率等；(3)实验室数据，血糖、红细胞分布宽度(red blood cell distribution width，RDW)等；(4)疾病严重程度相关数据，CURB-65评分、简化急性生理学评分Ⅱ、急性生理学评分Ⅲ(acute physiology score Ⅲ，APS-Ⅲ)等；(5)并发症信息，慢性阻塞性肺疾病、脑血管疾病、肾脏疾病、肝脏疾病、恶性肿瘤等；(6)治疗手段，有创机械通气、连续肾脏替代治疗、血管升压药治疗；(7)病原学数据；(8)预后指标等。实验室数据为入ICU后首日测量所得，若存在多次记录，则选择与疾病严重程度最相关的值。研究主要结局为1年全因死亡，次要结局为30 d、90 d全因死亡。
1.4 模型的构建及评估
在训练集中，采用LASSO回归初筛变量，通过多因素Cox回归确定SCAP患者预后的独立危险因素，构建预后模型并绘制列线图。采用一致性指数(concordance index，C指数)及受试者操作特征(receiver operator characteristic，ROC)曲线评估模型区分度，同时与临床常用的CURB-65评分的ROC曲线的区分度进行对比。采用校准曲线评估模型的预测准确性。根据模型计算全部患者1年死亡风险评分，选取训练集风险评分的中位数作为临界值，据此将训练集和验证集的患者各自划分成高风险组与低风险组，其中，训练集1363例患者中高风险组681例、低风险组682例，验证集580例患者中高风险组276例、低风险组304例。通过Kaplan-Meier生存曲线验证模型的风险分层能力。
1.5 统计学处理
采用R软件(版本4.3.3)进行统计分析。连续变量正态分布者以x±s表示，两组间比较采用成组t检验，非正态分布者以M(Q1，Q3)表示，组间比较采用Mann-Whitney U检验；分类变量以例(%)表示，组间比较采用χ²检验或Fisher确切概率法。缺失值>20%的变量予以剔除，其余缺失数据通过多重插补法处理。P<0.05为差异有统计学意义。
2 结果
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2.1 基线特征
总人群、训练集和验证集患者的基线特征情况见表1。研究人群中，老年患者(年龄>65岁)占比较高，年龄为66.0(54.0，77.0)岁；男性患者占比(58.1%)较高；白种人居多(占比56.7%)；SCAP患者30 d、90 d、1年的全因死亡率分别为25.9%、34.5%、42.6%；金黄色葡萄球菌为最常见病原体(占13.6%)，耐甲氧西林金黄色葡萄球菌次之(占5.51%)。训练集与验证集在临床基线特征上除白细胞计数有差异(P<0.05)外，其他指标差异无统计学意义(P>0.05)，具有可比性。
2.2 预后危险因素的筛选
采用LASSO回归对训练集56项临床特征进行筛选。通过引入正则化参数λ对各变量回归系数进行压缩和筛选，实现变量选择(图1A)；通过10折交叉验证曲线(图1B)确定最优惩罚参数，当λ取值为λ.min(即交叉验证曲线中偏似然偏差最小时的λ值)时，模型拟合效果最佳，初步筛选出29个潜在的预后相关变量。进一步采用多因素Cox比例风险模型进行向后逐步回归，最终确定7项独立危险因素(年龄、心率、RDW、APS-Ⅲ评分、脑血管疾病、肝脏疾病、恶性肿瘤)，其中恶性肿瘤的风险效应最为明显，可使死亡风险提升至2.007倍(表2)。
2.3 模型的构建及列线图绘制
将上述7个独立危险因素进行Cox回归分析，构建Cox回归模型，并绘制列线图(图2)可视化SCAP的预后风险。模型的训练集C指数为0.710(95%CI 0.681~0.769)，验证集C指数为0.688(95%CI 0.642~0.747)，提示该模型具有良好的区分度。
2.4 模型预测性能评估
ROC曲线分析显示，训练集SCAP患者30 d、90 d、1年死亡风险的ROC曲线下面积(area under the curve，AUC)分别为0.758、0.758、0.768，而验证集分别为0.714、0.729、0.738(图3)。另绘制CURB-65评分预测SCAP患者死亡风险的ROC曲线，结果显示，训练集30 d、90 d、1年死亡风险的AUC值分别为0.620、0.642、0.648，而验证集分别为0.590、0.592、0.616(图4)。
校准曲线显示，该模型的预测概率与实际概率仅有微小偏离，表明预测风险与实际情况有较好的一致性(图5)。经风险分组后，Kaplan-Meier生存分析结果显示，在训练集中，高风险组患者的1年死亡率高于低风险组(62.3% vs. 23.5%，P<0.0001)；在验证集中，高风险组患者的1年死亡率也高于低风险组(60.5% vs. 24.3%，P<0.0001)；表明模型具有可靠的死亡风险分层效能(图6)。
3 讨论
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作为CAP的重症类型，SCAP患者中长期死亡风险明显增高。本研究发现，SCAP患者的1年死亡率高达42.6%，与Cavallazzi等[12]的研究中ICU内CAP患者1年死亡率(47%)相近，这进一步凸显了开发精准风险评估工具的重要性。基于MIMIC-Ⅳ数据库，本研究通过两阶段的筛选，最终确定了年龄、心率、RDW、APS-Ⅲ、脑血管疾病、肝脏疾病及恶性肿瘤共7项独立危险因素，并构建了针对SCAP患者中长期死亡风险的预测模型。
目前对SCAP中长期预后的研究仍较为有限。本研究构建的预后模型在预测30 d至1年死亡风险方面展现了明显的优势，其AUC优于传统的CURB-65评分，可能是由于CURB-65评分系统主要聚焦于急性期生理参数，而未充分评估SCAP相关的失代偿并发症、社会因素及特定器官功能障碍[13]。Tuta-Quintero等[14]的前瞻性队列研究进一步验证了传统评分的局限性：PSI和CURB-65评分对CAP患者1年死亡率的预测效能较低，且随着随访时间延长其预测效能呈衰减趋势。相比于CURB-65评分，本研究将动态生理参数与慢性合并症进行整合，基于Cox比例风险模型构建了急性-慢性风险交互评估的框架，从而能更全面地解析SCAP患者的病理生理特征，明显提升中长期死亡风险预测的准确性。
本研究发现，心率、RDW及APS-Ⅲ评分是评估SCAP急性风险的关键指标。RDW作为红细胞异质性的量化参数(正常值为11%~14%)[15]，其升高提示红细胞生成障碍及存活异常，与多种疾病的病死率增高有关[16]。此外，RDW异常升高(>15%)已被明确为CAP患者90 d死亡风险增高的独立危险因素[17]，且有研究证实入院时RDW水平升高与成年CAP患者的死亡及严重并发症具有相关性[18]，进一步凸显了其在预后评估中的临床价值。
本研究发现，并发症如脑血管疾病、肝脏疾病及恶性肿瘤可明显增加SCAP患者的中长期死亡风险，与现有的研究高度一致。如Adamuz等[19]开展的一项纳入1284例CAP患者的队列研究发现，恶性肿瘤是1年全因死亡的独立危险因素；法国重症医学研究团队的研究进一步证实，在ICU收治的肺炎球菌性肺炎患者中，恶性肿瘤(HR=1.66)及肝脏疾病(HR=1.80)可使1年死亡风险明显增加[20]。吸入性肺炎占CAP的5%~15%[21]，其危险因素包括脑血管疾病[22]；而脑血管疾病与SCAP预后的关系可能通过吞咽功能障碍介导，其中40%~70%的脑卒中患者存在隐匿性误吸[23]。上述并发症可能通过免疫功能抑制或解剖屏障破坏等途径影响预后，但其具体机制仍需深入探究。
为实现临床转化，本研究构建了列线图模型，可实现SCAP患者30 d、90 d及1年死亡风险的多时间窗动态预测，并直观展示各风险因素贡献的权重。基于模型的风险分层显示，高风险组1年死亡率较低风险组明显增高，为临床实施差异化随访策略提供了量化依据。
然而，本研究仍存在一定局限性：(1)为回顾性研究，试验设计可能存在生存时间截断偏倚，尤其是对远期预后数据的完整性构成挑战，未来需通过前瞻性研究验证模型的稳健性；(2) MIMIC-Ⅳ数据库主要包含美国患者的资料，模型的跨人群、跨地区适用性需通过外部验证进一步确认；(3)关键临床参数的缺失可能会限制模型的临床转化潜力，因此未来的研究应通过前瞻性设计和多中心合作，系统完善预后评估的维度；(4)尚未对不同病原体感染患者临床特征的异质性及治疗反应的差异进行分层分析，后续研究需结合微生物学检测结果和长期随访数据深入分析，为精准治疗提供依据。
综上所述，本研究基于MIMIC-Ⅳ数据库，通过LASSO回归与多因素Cox回归分析筛选出年龄、心率、RDW、APS-Ⅲ等7项独立危险因素，构建了SCAP患者的中长期预后预测模型，该模型的预测效能优于传统CURB-65评分，并通过校准曲线与Kaplan-Meier生存分析提示其具有良好的校准度与风险分层能力，可为临床评估SCAP患者的预后提供有力工具。但未来仍需通过多中心前瞻性研究验证模型的外推性，同时还应探索整合炎性因子、代谢组学等指标以优化模型的预测性能，并深入研究并发症与SCAP病理生理机制的交互作用，为精准诊疗提供更坚实的理论依据。
基金
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  • 国家自然科学基金(81870961)
文献
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参考文献 引证文献
排序方式：
[1]
中华医学会呼吸病学分会. 中国成人社区获得性肺炎诊断和治疗指南(2016年版)[J]. 中华结核和呼吸杂志, 2016, 39(4): 253-279.
[2]
郭鑫龙, 赵志伟, 庞桂芬, 等. 红细胞体积分布宽度变异系数和血清IL-11、IL-31在间质性肺疾病诊断中的应用价值[J]. 解放军医学杂志, 2024, 49(11): 1295-1301.
[3]
Haessler S, Guo N, Deshpande A, et al. Etiology, treatments, and outcomes of patients with severe community-acquired pneumonia in a large U.S. sample[J]. Crit Care Med, 2022, 50(7): 1063-1071.
[4]
Umberto Meduri G, Shih MC, Bridges L, et al. Low-dose methylprednisolone treatment in critically ill patients with severe community-acquired pneumonia[J]. Intensive Care Med, 2022, 48(8): 1009-1023.
[5]
Ferrer M, Travierso C, Cilloniz C, et al. Severe community-acquired pneumonia: characteristics and prognostic factors in ventilated and non-ventilated patients[J]. PLoS One, 2018, 13(1): e0191721.
[6]
Capelastegui A, España PP, Quintana JM, et al. Validation of a predictive rule for the management of community-acquired pneumonia[J]. Eur Respir J, 2006, 27(1): 151-157.
[7]
Aujesky D, Fine MJ. The pneumonia severity index: a decade after the initial derivation and validation[J]. Clin Infect Dis, 2008, 47(Suppl 3): S133-S139.
[8]
Lim WS, van der Eerden MM, Laing R, et al. Defining community acquired pneumonia severity on presentation to hospital: an international derivation and validation study[J]. Thorax, 2003, 58(5): 377-382.
[9]
Grudzinska FS, Aldridge K, Hughes S, et al. Early identification of severe community-acquired pneumonia: a retrospective observational study[J]. BMJ Open Respir Res, 2019, 6(1): e000438.
[10]
Johnson AEW, Bulgarelli L, Shen L, et al. MIMIC-Ⅳ, a freely accessible electronic health record dataset[J]. Sci Data, 2023, 10(1): 1.
[11]
Metlay JP, Waterer GW, Long AC, et al. Diagnosis and treatment of adults with community-acquired pneumonia.:An official clinical practice guideline of the American thoracic society and infectious diseases society of America[J]. Am J Respir Crit Care Med, 2019, 200(7): e45-e67.
[12]
Cavallazzi R, Furmanek S, Arnold FW, et al. The burden of community-acquired pneumonia requiring admission to ICU in the United States[J]. Chest, 2020, 158(3): 1008-1016.
[13]
Niederman MS. Making sense of scoring systems in community acquired pneumonia[J]. Respirology, 2009, 14(3): 327-335.
[14]
Tuta-Quintero E, Bastidas AR, Guerrón-Gómez G, et al. Performance of risk scores in predicting mortality at 3, 6, and 12 months in patients diagnosed with community-acquired pneumonia[J]. BMC Pulm Med, 2024, 24(1): 334.
[15]
Lippi G, Dipalo M, Teti L, et al. Relationship between red blood cell distribution width and prognostic biomarkers in patients admitted to the emergency department with acute infections[J]. Eur J Intern Med, 2013, 24(2): e15-e16.
[16]
Salvagno GL, Sanchis-Gomar F, Picanza A, et al. Red blood cell distribution width: a simple parameter with multiple clinical applications[J]. Crit Rev Clin Lab Sci, 2015, 52(2): 86-105.
[17]
Braun E, Kheir J, Mashiach T, et al. Is elevated red cell distribution width a prognostic predictor in adult patients with community acquired pneumonia?[J]. BMC Infect Dis, 2014, 14: 129.
[18]
Braun E, Domany E, Kenig Y, et al. Elevated red cell distribution width predicts poor outcome in young patients with community acquired pneumonia[J]. Crit Care, 2011, 15(4): R194.
[19]
Adamuz J, Viasus D, Jiménez-Martínez E, et al. Incidence, timing and risk factors associated with 1-year mortality after hospitalization for community-acquired pneumonia[J]. J Infect, 2014, 68(6): 534-541.
[20]
Dupuis C, Sabra A, Patrier J, et al. Burden of pneumococcal pneumonia requiring ICU admission in France: 1-year prognosis, resources use, and costs[J]. Crit Care, 2021, 25(1): 24.
[21]
Marik PE. Aspiration pneumonitis and aspiration pneumonia[J]. N Engl J Med, 2001, 344(9): 665-671.
[22]
佘君, 丁建文, 申捷. 成人吸入性肺炎诊断和治疗专家建议[J]. 国际呼吸杂志, 2022, 42(2): 86-96.
[23]
Almirall J, Boixeda R, de la Torre MC, et al. Aspiration pneumonia: a renewed perspective and practical approach[J]. Respir Med, 2021, 185: 106485.
2025年第50卷第4期
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doi: 10.11855/j.issn.0577-7402.1759.2025.0305
  • 接收时间：2024-11-05
  • 首发时间：2025-10-30
  • 出版时间：2025-04-28
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  • 收稿日期：2024-11-05
  • 录用日期：2025-02-21
基金
National Natural Science Foundation of China(81870961)
国家自然科学基金(81870961)
作者信息
    1空军军医大学西京医院重症医学科，陕西西安 710032
    2空军军医大学西京医院麻醉与围术期医学科，陕西西安 710032

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Number of
genus		 种数
Number of
species		 占总种数比例
Percentage of
total species (%)		 属
Genus		 种数
Number of
species		 占总种数比例
Percentage of total
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鹅膏菌科Amanitaceae 2 11 5.26 鹅膏菌属 Amanita 10 4.78
小菇科 Mycenaceae 2 12 5.74 丝盖伞属 Inocybe 5 2.39
多孔菌科 Polyporaceae 8 14 6.70 蜡蘑属 Laccaria 5 2.39
红菇科 Russulaceae 3 23 11.00 小皮伞属 Marasmius 6 2.87
小菇属 Mycena 11 5.26
光柄菇属 Pluteus 5 2.39
红菇属 Russula 17 8.13
栓菌属 Trametes 5 2.39
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