Nomogram Models to Predict Postoperative Hyperlactatemia in Patients Undergoing Elective Cardiac Surgery

Objectives: Postoperative hyperlactatemia (POHL) is common in patients undergoing cardiac surgery and is associated with poor outcomes. The purpose of this study was to develop and validate two predictive models for POHL in patients undergoing elective cardiac surgery (ECS).Methods: We conducted a m...

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Autores principales:	Dashuai Wang, Su Wang, Jia Wu, Sheng Le, Fei Xie, Ximei Li, Hongfei Wang, Xiaofan Huang, Xinling Du, Anchen Zhang
Formato:	article
Lenguaje:	EN
Publicado:	Frontiers Media S.A. 2021
Materias:	cardiac surgery postoperative hyperlactatemia prediction model nomogram risk factor Medicine (General) R5-920
Acceso en línea:	https://doaj.org/article/f0fdd0b8f5954a8baa3301266e3e3aae
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spelling	oai:doaj.org-article:f0fdd0b8f5954a8baa3301266e3e3aae2021-12-02T08:33:54ZNomogram Models to Predict Postoperative Hyperlactatemia in Patients Undergoing Elective Cardiac Surgery2296-858X10.3389/fmed.2021.763931https://doaj.org/article/f0fdd0b8f5954a8baa3301266e3e3aae2021-12-01T00:00:00Zhttps://www.frontiersin.org/articles/10.3389/fmed.2021.763931/fullhttps://doaj.org/toc/2296-858XObjectives: Postoperative hyperlactatemia (POHL) is common in patients undergoing cardiac surgery and is associated with poor outcomes. The purpose of this study was to develop and validate two predictive models for POHL in patients undergoing elective cardiac surgery (ECS).Methods: We conducted a multicenter retrospective study enrolling 13,454 adult patients who underwent ECS. All patients involved in the analysis were randomly assigned to a training set and a validation set. Univariate and multivariate analyses were performed to identify risk factors for POHL in the training cohort. Based on these independent predictors, the nomograms were constructed to predict the probability of POHL and were validated in the validation cohort.Results: A total of 1,430 patients (10.6%) developed POHL after ECS. Age, preoperative left ventricular ejection fraction, renal insufficiency, cardiac surgery history, intraoperative red blood cell transfusion, and cardiopulmonary bypass time were independent predictors and were used to construct a full nomogram. The second nomogram was constructed comprising only the preoperative factors. Both models showed good predictive ability, calibration, and clinical utility. According to the predicted probabilities, four risk groups were defined as very low risk (<0.05), low risk (0.05–0.1), medium risk (0.1–0.3), and high risk groups (>0.3), corresponding to scores of ≤ 180 points, 181–202 points, 203–239 points, and >239 points on the full nomogram, respectively.Conclusions: We developed and validated two nomogram models to predict POHL in patients undergoing ECS. The nomograms may have clinical utility in risk estimation, risk stratification, and targeted interventions.Dashuai WangSu WangJia WuSheng LeFei XieXimei LiHongfei WangXiaofan HuangXinling DuAnchen ZhangFrontiers Media S.A.articlecardiac surgerypostoperative hyperlactatemiaprediction modelnomogramrisk factorMedicine (General)R5-920ENFrontiers in Medicine, Vol 8 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	cardiac surgery postoperative hyperlactatemia prediction model nomogram risk factor Medicine (General) R5-920
spellingShingle	cardiac surgery postoperative hyperlactatemia prediction model nomogram risk factor Medicine (General) R5-920 Dashuai Wang Su Wang Jia Wu Sheng Le Fei Xie Ximei Li Hongfei Wang Xiaofan Huang Xinling Du Anchen Zhang Nomogram Models to Predict Postoperative Hyperlactatemia in Patients Undergoing Elective Cardiac Surgery
description	Objectives: Postoperative hyperlactatemia (POHL) is common in patients undergoing cardiac surgery and is associated with poor outcomes. The purpose of this study was to develop and validate two predictive models for POHL in patients undergoing elective cardiac surgery (ECS).Methods: We conducted a multicenter retrospective study enrolling 13,454 adult patients who underwent ECS. All patients involved in the analysis were randomly assigned to a training set and a validation set. Univariate and multivariate analyses were performed to identify risk factors for POHL in the training cohort. Based on these independent predictors, the nomograms were constructed to predict the probability of POHL and were validated in the validation cohort.Results: A total of 1,430 patients (10.6%) developed POHL after ECS. Age, preoperative left ventricular ejection fraction, renal insufficiency, cardiac surgery history, intraoperative red blood cell transfusion, and cardiopulmonary bypass time were independent predictors and were used to construct a full nomogram. The second nomogram was constructed comprising only the preoperative factors. Both models showed good predictive ability, calibration, and clinical utility. According to the predicted probabilities, four risk groups were defined as very low risk (<0.05), low risk (0.05–0.1), medium risk (0.1–0.3), and high risk groups (>0.3), corresponding to scores of ≤ 180 points, 181–202 points, 203–239 points, and >239 points on the full nomogram, respectively.Conclusions: We developed and validated two nomogram models to predict POHL in patients undergoing ECS. The nomograms may have clinical utility in risk estimation, risk stratification, and targeted interventions.
format	article
author	Dashuai Wang Su Wang Jia Wu Sheng Le Fei Xie Ximei Li Hongfei Wang Xiaofan Huang Xinling Du Anchen Zhang
author_facet	Dashuai Wang Su Wang Jia Wu Sheng Le Fei Xie Ximei Li Hongfei Wang Xiaofan Huang Xinling Du Anchen Zhang
author_sort	Dashuai Wang
title	Nomogram Models to Predict Postoperative Hyperlactatemia in Patients Undergoing Elective Cardiac Surgery
title_short	Nomogram Models to Predict Postoperative Hyperlactatemia in Patients Undergoing Elective Cardiac Surgery
title_full	Nomogram Models to Predict Postoperative Hyperlactatemia in Patients Undergoing Elective Cardiac Surgery
title_fullStr	Nomogram Models to Predict Postoperative Hyperlactatemia in Patients Undergoing Elective Cardiac Surgery
title_full_unstemmed	Nomogram Models to Predict Postoperative Hyperlactatemia in Patients Undergoing Elective Cardiac Surgery
title_sort	nomogram models to predict postoperative hyperlactatemia in patients undergoing elective cardiac surgery
publisher	Frontiers Media S.A.
publishDate	2021
url	https://doaj.org/article/f0fdd0b8f5954a8baa3301266e3e3aae
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Nomogram Models to Predict Postoperative Hyperlactatemia in Patients Undergoing Elective Cardiac Surgery

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