Nomogram Prediction Model of Hypernatremia on Mortality in Critically Ill Patients

Abstract

Objective

To investigate the value of hypernatremia in the intensive care unit (ICU) for the risk prediction of mortality in severe patients.

Methods

Clinical data of critically ill patients admitted to the ICU of Beijing Friendship Hospital, were collected for retrospective analysis. Univariate and multivariate logistic regression analyses were employed to analyze the influencing factors. Nomograms predicting the mortality were constructed with R software and validated with repeated sampling.

Results

A total of 442 cases were eligible for this study. Hypernatremia within 48 hours of ICU admission, change in sodium concentration (CNa+) within 48 hours, septic shock, APACHE II score, hyperlactatemia within 48 hours, use of continuous renal replacement therapy (CRRT) within 48 hours, and the use of mechanical ventilation (MV) within 48 hours of ICU admission were all identified as independent risk factors for death within 28 days of ICU admission. These predictors were included in a nomogram of 28-day mortality in severe patients, which was constructed using R software.

Conclusion

The nomogram could predict the individualized risk of 28-day mortality based on the above factors. The model has better discrimination and accuracy and has high clinical application value.

Keywords:

• intensive care unit
• 28 day mortality
• serum sodium
• hypernatremia

Data Sharing Statement

All data generated or analyzed during this study are included in this published article or are available from the corresponding author on reasonable request.

Ethics Approval

This study was approved by the Professional Committee on bioethics of Beijing Friendship Hospital (No. 2022-P2-083-01). All methods were carried out in accordance with relevant guidelines and regulations. Professional Committee on bioethics of Beijing Friendship Hospital waived the need to informed consent for this study.

Acknowledgments

The authors would like to thank the database search support provided by Beijing Friendship Hospital affiliated with Capital Medical University.

Author Contributions

All authors made a significant contribution to the work reported, whether that is in the conception, study design, execution, acquisition of data, analysis and interpretation, or in all these areas; took part in drafting, revising or critically reviewing the article; gave final approval of the version to be published; have agreed on the journal to which the article has been submitted; and agree to be accountable for all aspects of the work.

Disclosure

The authors declare that there are no conflicts of interest.

Additional information

Funding

The study did not receive any specific funding from funding agencies in the public, commercial or non-profit sectors.