Developing and validating a prognostic model to predict ICU mortality in patients with sepsis-associated thrombocytopenia: a retrospective cohort study based on MIMIC-IV

Objective Given the high morbidity and mortality of patients with sepsis-associated thrombocytopenia (SATP) in the intensive care unit, this study retrospectively analysed the influencing factors for poor prognosis in patients with SATP using the MIMIC database, constructed a nomogram model and veri...

Full description

Saved in:
Bibliographic Details
Main Authors: Yufeng Li, Miao Zhang, Pingping Li, Wei Ye, Xing Tang, Jiaqiong Li, Shucun Liu
Format: Article
Language:English
Published: BMJ Publishing Group 2025-08-01
Series:BMJ Open
Online Access:https://bmjopen.bmj.com/content/15/8/e099691.full
Tags: Add Tag
No Tags, Be the first to tag this record!
_version_ 1849390816678641664
author Yufeng Li
Miao Zhang
Pingping Li
Wei Ye
Xing Tang
Jiaqiong Li
Shucun Liu
author_facet Yufeng Li
Miao Zhang
Pingping Li
Wei Ye
Xing Tang
Jiaqiong Li
Shucun Liu
author_sort Yufeng Li
collection DOAJ
description Objective Given the high morbidity and mortality of patients with sepsis-associated thrombocytopenia (SATP) in the intensive care unit, this study retrospectively analysed the influencing factors for poor prognosis in patients with SATP using the MIMIC database, constructed a nomogram model and verified the predictive performance of the model.Design A retrospective cohort study.Setting The data from MIMIC-IV, V.2.2.Clinical characteristics The clinical features of SATP, including demographics, comorbidities, vital signs, laboratory parameters, treatments and clinical management, were extracted from the MIMIC-IV database.Methods 1409 patients with SATP were included in this study and randomly divided into a training set and a validation set in a ratio of 7:3. The least absolute shrinkage and selection operator and multivariable Cox regression analysis were used to determine the optimal predictors and establish a prediction model. The receiver operating characteristic curve, calibration curve and decision curve analysis (DCA) were used to verify the accuracy and application value of the model.Results The nomogram model incorporates nine factors, including clinical characteristics, laboratory test indicators, comorbidities and treatment methods, which were identified as predictors of SATP and used to construct the model. The area under the curve of the model was 0.868 (95% CI: 0.794 to 0.942) in the training set and 0.836 (95% CI: 0.681 to 0.991) in the validation set. The calibration curve and DCA confirmed the clinical application value of the nomogram.Conclusions The constructed nomogram for predicting patients with SATP has favourable predictive ability and is helpful to further optimise clinical management strategies.
format Article
id doaj-art-6bfb900bf311445ba6dfe2aa178f4f82
institution Kabale University
issn 2044-6055
language English
publishDate 2025-08-01
publisher BMJ Publishing Group
record_format Article
series BMJ Open
spelling doaj-art-6bfb900bf311445ba6dfe2aa178f4f822025-08-20T03:41:19ZengBMJ Publishing GroupBMJ Open2044-60552025-08-0115810.1136/bmjopen-2025-099691Developing and validating a prognostic model to predict ICU mortality in patients with sepsis-associated thrombocytopenia: a retrospective cohort study based on MIMIC-IVYufeng Li0Miao Zhang1Pingping Li2Wei Ye3Xing Tang4Jiaqiong Li5Shucun Liu6Department of Critical Care Medicine, Xuzhou Central Hospital, Xuzhou, Jiangsu, ChinaDepartment of Critical Care Medicine, Sishui County People’s Hospital, Jining, Shandong, ChinaThe Xuzhou Clinical college, Xuzhou Medical University, Xuzhou, Jiangsu, ChinaThe Xuzhou Clinical college, Xuzhou Medical University, Xuzhou, Jiangsu, ChinaThe Xuzhou Clinical college, Xuzhou Medical University, Xuzhou, Jiangsu, ChinaThe Xuzhou Clinical college, Xuzhou Medical University, Xuzhou, Jiangsu, ChinaThe Xuzhou Clinical college, Xuzhou Medical University, Xuzhou, Jiangsu, ChinaObjective Given the high morbidity and mortality of patients with sepsis-associated thrombocytopenia (SATP) in the intensive care unit, this study retrospectively analysed the influencing factors for poor prognosis in patients with SATP using the MIMIC database, constructed a nomogram model and verified the predictive performance of the model.Design A retrospective cohort study.Setting The data from MIMIC-IV, V.2.2.Clinical characteristics The clinical features of SATP, including demographics, comorbidities, vital signs, laboratory parameters, treatments and clinical management, were extracted from the MIMIC-IV database.Methods 1409 patients with SATP were included in this study and randomly divided into a training set and a validation set in a ratio of 7:3. The least absolute shrinkage and selection operator and multivariable Cox regression analysis were used to determine the optimal predictors and establish a prediction model. The receiver operating characteristic curve, calibration curve and decision curve analysis (DCA) were used to verify the accuracy and application value of the model.Results The nomogram model incorporates nine factors, including clinical characteristics, laboratory test indicators, comorbidities and treatment methods, which were identified as predictors of SATP and used to construct the model. The area under the curve of the model was 0.868 (95% CI: 0.794 to 0.942) in the training set and 0.836 (95% CI: 0.681 to 0.991) in the validation set. The calibration curve and DCA confirmed the clinical application value of the nomogram.Conclusions The constructed nomogram for predicting patients with SATP has favourable predictive ability and is helpful to further optimise clinical management strategies.https://bmjopen.bmj.com/content/15/8/e099691.full
spellingShingle Yufeng Li
Miao Zhang
Pingping Li
Wei Ye
Xing Tang
Jiaqiong Li
Shucun Liu
Developing and validating a prognostic model to predict ICU mortality in patients with sepsis-associated thrombocytopenia: a retrospective cohort study based on MIMIC-IV
BMJ Open
title Developing and validating a prognostic model to predict ICU mortality in patients with sepsis-associated thrombocytopenia: a retrospective cohort study based on MIMIC-IV
title_full Developing and validating a prognostic model to predict ICU mortality in patients with sepsis-associated thrombocytopenia: a retrospective cohort study based on MIMIC-IV
title_fullStr Developing and validating a prognostic model to predict ICU mortality in patients with sepsis-associated thrombocytopenia: a retrospective cohort study based on MIMIC-IV
title_full_unstemmed Developing and validating a prognostic model to predict ICU mortality in patients with sepsis-associated thrombocytopenia: a retrospective cohort study based on MIMIC-IV
title_short Developing and validating a prognostic model to predict ICU mortality in patients with sepsis-associated thrombocytopenia: a retrospective cohort study based on MIMIC-IV
title_sort developing and validating a prognostic model to predict icu mortality in patients with sepsis associated thrombocytopenia a retrospective cohort study based on mimic iv
url https://bmjopen.bmj.com/content/15/8/e099691.full
work_keys_str_mv AT yufengli developingandvalidatingaprognosticmodeltopredicticumortalityinpatientswithsepsisassociatedthrombocytopeniaaretrospectivecohortstudybasedonmimiciv
AT miaozhang developingandvalidatingaprognosticmodeltopredicticumortalityinpatientswithsepsisassociatedthrombocytopeniaaretrospectivecohortstudybasedonmimiciv
AT pingpingli developingandvalidatingaprognosticmodeltopredicticumortalityinpatientswithsepsisassociatedthrombocytopeniaaretrospectivecohortstudybasedonmimiciv
AT weiye developingandvalidatingaprognosticmodeltopredicticumortalityinpatientswithsepsisassociatedthrombocytopeniaaretrospectivecohortstudybasedonmimiciv
AT xingtang developingandvalidatingaprognosticmodeltopredicticumortalityinpatientswithsepsisassociatedthrombocytopeniaaretrospectivecohortstudybasedonmimiciv
AT jiaqiongli developingandvalidatingaprognosticmodeltopredicticumortalityinpatientswithsepsisassociatedthrombocytopeniaaretrospectivecohortstudybasedonmimiciv
AT shucunliu developingandvalidatingaprognosticmodeltopredicticumortalityinpatientswithsepsisassociatedthrombocytopeniaaretrospectivecohortstudybasedonmimiciv