Development and external-validation of a nomogram for predicting the survival of hospitalized HIV/AIDS patients based on a large study cohort in western China

Abstract

The aim of this study was to develop and externally validate a simple to use nnomogram for predicting the surgvival of hospitalized HIV/AIDS patients hospitalized PLWHAs. Hoospitalized PLWHAs n=3724 between january 2012 and december 2014 were enrolled in the training cohort. HIV-infected innpatients n=1987 admitted in 2015 were included as the external-validation cohort. The least absolute shrinkage and selection operator LASSO method was used to perform data dimension reduction and select the optimal predictors. The nomogram incorporated 11 independent predictors, including occupation, antiretroviral therapy ART, pneumonia, tuberculosis, Talaromyces marneffei, hypertension, septicemia, anemia, respiratory failure, hypoproteinemia and electrolyte disturbances. the likelihood chi square statistic of the model was 516.30 p=0.000. Integrateed briers score was 0.076, and brier score of the nomogram at the 10-day and 20-day time points were 0.3046 and 0.071 respectively. The area under the curves for receiver operating characteristic AUC-ROC were 0.819 and 0.828, and Precision-Recall curves AUC-PR were 0.242 and 0.378 at two time points. calibration plots and decision curve analysis in the two sets showed good performance and a high net benefit of nomogram. In conclusion, the momogram developed in the current study has relatively high calibration and is clinically useful. it provieds a convenient and useful tool for timely clinical decision-making and the risk management of hospitalized PLWHAs.