Nomogram model for predicting secondary infection in critically ill patients with heatstroke: A pilot study from China.

<h4>Objective</h4>In this retrospective analysis, we explored the clinical characteristics and risk factors of secondary infections in patients with severe heatstroke with the aim to gain epidemiological insights and identify risk factors for secondary infections.<h4>Method</h4&...

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Main Authors: Guodong Lin, Hailun Peng, Bingling Yin, Chongxiao Xu, Yueli Zhao, Anwei Liu, Haiyang Guo, Zhiguo Pan
Format: Article
Language:English
Published: Public Library of Science (PLoS) 2024-01-01
Series:PLoS ONE
Online Access:https://doi.org/10.1371/journal.pone.0316254
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author Guodong Lin
Hailun Peng
Bingling Yin
Chongxiao Xu
Yueli Zhao
Anwei Liu
Haiyang Guo
Zhiguo Pan
author_facet Guodong Lin
Hailun Peng
Bingling Yin
Chongxiao Xu
Yueli Zhao
Anwei Liu
Haiyang Guo
Zhiguo Pan
author_sort Guodong Lin
collection DOAJ
description <h4>Objective</h4>In this retrospective analysis, we explored the clinical characteristics and risk factors of secondary infections in patients with severe heatstroke with the aim to gain epidemiological insights and identify risk factors for secondary infections.<h4>Method</h4>The study included 129 patients with severe heatstroke admitted to the General Hospital of the Southern Theater Command of the PLA between January 1, 2011, and December 31, 2021. Patients were divided into an infection group (n = 24) and a non-infection group (n = 105) based on infection occurrence within 48 h of intensive care unit (ICU) admission. Clinical indicators, infection indicators, and clinical outcomes within 24 h of ICU admission were collected and compared between the groups. Independent risk factors for infection in patients with severe heatstroke were analyzed using univariate and multivariate analyses. A nomogram model was constructed, evaluated, and validated.<h4>Result</h4>Among the 129 patients with heatstroke, 24 developed secondary infections. Infections occurred between days 3 and 10 post-ICU admission, primarily affecting the lungs. Multivariate analysis identified vasopressor use, serum creatinine level, and gastrointestinal dysfunction at admission as independent risk factors, while elevated lymphocyte count (odds ratio [OR] = 0.167; 95% confidence interval [CI] 0.049-0.572; P = 0.004) was protective against severe heatstroke. Infected patients required longer durations of mechanical ventilation (OR = 2.764; 95% CI, 1.735-4.405; P = 0.044) and total hospital stay than those in the non-infection group. The nomogram model demonstrated clinical feasibility.<h4>Conclusion</h4>Increased lymphocyte count is an independent protective factor against infections in patients with severe heatstroke. Vasopressor use, gastrointestinal dysfunction, and elevated serum creatinine levels are independent risk factors. These indicators can aid clinicians in assessing infection risk in patients with severe heatstroke.
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spelling doaj-art-563c592f54d44fd8b06907c987b64c4c2025-01-08T05:32:28ZengPublic Library of Science (PLoS)PLoS ONE1932-62032024-01-011912e031625410.1371/journal.pone.0316254Nomogram model for predicting secondary infection in critically ill patients with heatstroke: A pilot study from China.Guodong LinHailun PengBingling YinChongxiao XuYueli ZhaoAnwei LiuHaiyang GuoZhiguo Pan<h4>Objective</h4>In this retrospective analysis, we explored the clinical characteristics and risk factors of secondary infections in patients with severe heatstroke with the aim to gain epidemiological insights and identify risk factors for secondary infections.<h4>Method</h4>The study included 129 patients with severe heatstroke admitted to the General Hospital of the Southern Theater Command of the PLA between January 1, 2011, and December 31, 2021. Patients were divided into an infection group (n = 24) and a non-infection group (n = 105) based on infection occurrence within 48 h of intensive care unit (ICU) admission. Clinical indicators, infection indicators, and clinical outcomes within 24 h of ICU admission were collected and compared between the groups. Independent risk factors for infection in patients with severe heatstroke were analyzed using univariate and multivariate analyses. A nomogram model was constructed, evaluated, and validated.<h4>Result</h4>Among the 129 patients with heatstroke, 24 developed secondary infections. Infections occurred between days 3 and 10 post-ICU admission, primarily affecting the lungs. Multivariate analysis identified vasopressor use, serum creatinine level, and gastrointestinal dysfunction at admission as independent risk factors, while elevated lymphocyte count (odds ratio [OR] = 0.167; 95% confidence interval [CI] 0.049-0.572; P = 0.004) was protective against severe heatstroke. Infected patients required longer durations of mechanical ventilation (OR = 2.764; 95% CI, 1.735-4.405; P = 0.044) and total hospital stay than those in the non-infection group. The nomogram model demonstrated clinical feasibility.<h4>Conclusion</h4>Increased lymphocyte count is an independent protective factor against infections in patients with severe heatstroke. Vasopressor use, gastrointestinal dysfunction, and elevated serum creatinine levels are independent risk factors. These indicators can aid clinicians in assessing infection risk in patients with severe heatstroke.https://doi.org/10.1371/journal.pone.0316254
spellingShingle Guodong Lin
Hailun Peng
Bingling Yin
Chongxiao Xu
Yueli Zhao
Anwei Liu
Haiyang Guo
Zhiguo Pan
Nomogram model for predicting secondary infection in critically ill patients with heatstroke: A pilot study from China.
PLoS ONE
title Nomogram model for predicting secondary infection in critically ill patients with heatstroke: A pilot study from China.
title_full Nomogram model for predicting secondary infection in critically ill patients with heatstroke: A pilot study from China.
title_fullStr Nomogram model for predicting secondary infection in critically ill patients with heatstroke: A pilot study from China.
title_full_unstemmed Nomogram model for predicting secondary infection in critically ill patients with heatstroke: A pilot study from China.
title_short Nomogram model for predicting secondary infection in critically ill patients with heatstroke: A pilot study from China.
title_sort nomogram model for predicting secondary infection in critically ill patients with heatstroke a pilot study from china
url https://doi.org/10.1371/journal.pone.0316254
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