Construction and evaluation of acquired weakness nomogram model in patients with mechanical ventilation in intensive care unit.

Abstract

The incidence of intensive care unit acquired weakness (ICU-AW) has shown an increasing trend with still a lack of effective treatment options. The early assessment of the risk of developing ICU-AW can provide patients with targeted interventions. This study aimed to determine the independent risk factors of ICU-AW in patients receiving mechanical ventilation (MV) and develop a nomogram and verify its predictive efficacy. This observational study included patients receiving MV therapy in the ICU of our hospital between January 2020 and January 2023. They were divided into the ICU-AW and non-ICU-AW groups. The training cohort (n = 264) and the validation cohort (n = 143) were constructed. Multivariate logistic regression analyses were used to select the risk factors, and a nomogram model was established. Calibration, receiver operating characteristic (ROC), and decision curves were used to evaluate the effectiveness of the model. The MV duration (OR = 1.24, 95%CI[1.11, 1.38]), APACHE II score (OR = 1.34, 95%CI[1.20, 1.50]), SOFA score (OR = 1.36, 95%CI[1.21, 1.53]), age (OR = 1.05, 95%CI[1.00, 1.10]), nerve blockers (OR = 3.26, 95%CI[1.34, 7.92]), and diabetes mellitus (OR = 3.12, 95%CI[1.10, 8.87]) were independent risk factors for ICU-AW. The nomogram had good predictive efficacy for both the training (area under the curve (AUC) = 0.950, 95%CI [0.93, 0.97]) and validation cohorts (AUC = 0.823, 95%CI [0.75, 0.89]). The MV duration, APACHE II, SOFA, age, use of nerve blockers, and diabetes mellitus are independent risk factors for ICU-AW. The nomogram model based on them had good predictive efficacy and may be clinically useful.