Accurate assessment and timely intervention play a crucial role in ameliorating poor short-term prognosis of acute pulmonary embolism (APE) patients. The currently employed scoring models exhibit a degree of complexity, and some models may not comprehensively incorporate relevant indicators, thereby imposing limitations on the evaluative efficacy. Our study aimed to construct and externally validate a nomogram that predicts 30-day all-cause mortality risk in APE patients. Clinical data from APE patients in Intensive Care-IV database was included as a training cohort. Additionally, we utilized our hospital's APE database as an external validation cohort. The nomogram was developed, and its predictive ability was evaluated using receiver operating characteristic (ROC) curves, calibration plots and decision curve analysis. A collective of 1332 patients and 336 patients were respectively enrolled as the training cohort and the validation cohort in this study. Five variables including age, malignancy, oxygen saturation, blood glucose, and the use of vasopressor, were identified based on the results of the multivariate Cox regression model. The ROC value for the nomogram in the training cohort yielded 0.765, whereas in the validation group, it reached 0.907. Notably, these values surpassed the corresponding ROC values for the Pulmonary Embolism Severity Index, which were 0.713 in the training cohort and 0.754 in the validation cohort. The nomogram including five indicators had a good performance in predicting short-term prognosis in patients with APE, which was easier to apply and provided better recommendations for clinical decision-making.

中文翻译：

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用于预测急性肺栓塞患者短期预后的列线图的开发和外部验证

准确的评估和及时的干预对于改善急性肺栓塞（APE）患者不良的短期预后至关重要。目前采用的评分模型具有一定的复杂性，部分模型可能未全面纳入相关指标，从而限制了评价效果。我们的研究旨在构建并外部验证列线图，预测 APE 患者 30 天全因死亡风险。重症监护 IV 数据库中 APE 患者的临床数据被纳入训练队列。此外，我们利用我们医院的 APE 数据库作为外部验证队列。开发了列线图，并使用受试者工作特征 (ROC) 曲线、校准图和决策曲线分析评估其预测能力。本研究共招募了 1332 名患者和 336 名患者作为训练队列和验证队列。根据多元 Cox 回归模型的结果确定了五个变量，包括年龄、恶性肿瘤、氧饱和度、血糖和血管加压药的使用。训练组中列线图的 ROC 值为 0.765，而验证组中则达到 0.907。值得注意的是，这些值超过了肺栓塞严重指数的相应 ROC 值，训练队列中为 0.713，验证队列中为 0.754。包含5个指标的列线图在预测APE患者的短期预后方面具有良好的性能，更易于应用，为临床决策提供更好的建议。