Development and internal validation of a nomogram for predicting mechanical ventilation requirement in adult tetanus patients: a dual-center retrospective study

Development and internal validation of a nomogram for predicting mechanical ventilation requirement in adult tetanus patients: a dual-center retrospective study. Download PDF Abstract To develop and internally validate a nomogram for predicting mechanical ventilation (MV) requirement in adult patients with tetanus. This retrospective dual-center study included 227 adult tetanus patients admitted to two tertiary hospitals in Southern Jiangxi, China, between January 2012 and December 2024.

MV requirement, defined as the initiation of invasive mechanical ventilation for respiratory failure, served as the primary outcome. Thirty-eight candidate predictors encompassing demographics, clinical characteristics, and laboratory biomarkers were evaluated. Missing data (3.2%) were imputed using random forest-based multiple imputation.

LASSO regression was employed for feature selection, followed by multivariable logistic regression to construct the prediction model. Internal validation was performed using 10-fold cross-validation and bootstrap resampling (1,000 iterations). Model discrimination was assessed by the area under the ROC curve (AUC), calibration by calibration plots and the Hosmer-Lemeshow test, and clinical utility by decision curve analysis (DCA).

Medical Disclaimer: This article is for informational purposes only and does not constitute medical advice. Always consult with qualified healthcare professionals for medical decisions and treatment options.