Development and validation of a prediction model for in-hospital mortality in older adults with acute poisoning
Year: 2025
Type: article
Study design: Observational Study
Abstract: Background This study aimed to develop a mortality risk model for older adult patients with acute poisoning, addressing the lack of age-specific tools. Methods A retrospective study was conducted to develop and validate a nomogram for predicting in-hospital mortality. The training cohort included 452 patients (62.2% men; 51.3% ≥70 years; main poisoning types: pesticides, 39.9%; drugs, 28.2%), with 133 patients in an external validation cohort. Independent risk factors were identified through logistic regression, and the nomogram was developed in R. Model performance was assessed using area under the curve, sensitivity, specificity, calibration, and decision curve analysis; external validation was performed using data from another hospital. Results Multivariate analysis identified independent risk factors for in-hospital mortality: age ≥70 years (odds ratio = 2.66), heart rate <60 or ≥110 bpm (odds ratio = 2.00), lactate ≥3.5 mmol/L (odds ratio = 2.61), white blood count ≥15 × 10 9 /L (odds ratio = 3.46), and myoglobin ≥1000 ng/mL (odds ratio = 8.62). Internal validation showed an area under the curve of 0.824, sensitivity of 72.4%, and specificity of 76.1%. External validation showed an area under the curve of 0.854, sensitivity of 85.3%, and specificity of 75.8%. Conclusion The nomogram effectively predicts in-hospital mortality in older adult patients with acute poisoning, outperforming conventional scores. It enables rapid risk stratification within 24 h of admission to guide early intervention.
Authors: Ke Li, Jianping Ye, Yahui Tang, Longwang Chen, Zhongqiu Lu
Language: English
Subfield: Emergency Medicine
Field: Medicine
Domain: Health Sciences
Open Access status: gold
Estimated APC paid: $4,155
OpenAlex ID: W4417258928