The following is the summary of “Establishment of a risk prediction model for prolonged mechanical ventilation after lung transplantation: a retrospective cohort study” published in the January 2023 issue of Pulmonary medicine by Gao, et al.

Mortality rates are higher for patients requiring prolonged mechanical ventilation (PMV), often defined as mechanical ventilation for more than 72 hours following lung transplantation with or without tracheostomy. However, the risk factors for PMV following a lung transplant have yet to be determined. Therefore, the goal of the current investigation was to create a novel grading system for detecting PMV following lung transplantation. For this analysis, researchers looked into the lives of 141 people who had undergone lung transplantation. 

Patients were assigned to either a PMV or NPMV group. Researchers analyzed potential risk variables for PMV using univariate and multivariate logistic regression. Following the multivariate analysis, a risk nomogram was developed, and the model’s performance in terms of calibration, discrimination, and clinical utility was investigated. After conducting a multivariate analysis, eight factors were significantly associated with PMV and were subsequently included as risk factors in the nomogram. These factors were as follows: body mass index (BMI, P=0.036); primary diagnosis as idiopathic pulmonary fibrosis (IPF, P=0.038); pulmonary hypertension (PAH, P=0.034); primary graft dysfunction grading (PGD) at T_O, (P=0.011); cold ischemia time (CIT P=0.012); and three ventilation parameters (peak inspiratory pressure [PIP, P<0.001], dynamic compliance [Cdyn, P=0.001], and P/F ratio [P = 0.015]) at T_O. 

The nomogram’s area under the curve of 0.895 demonstrates its excellent discriminatory power. Further, research of both the calibration curve and the decision curve revealed promising results. An innovative nomogram was developed to estimate individual risk of developing PMV for patients following lung transplantation; this information may help direct preventative measures against this adverse event.

Source: bmcpulmmed.biomedcentral.com/articles/10.1186/s12890-023-02307-9