Risk factors for prolonged ICU duration after surgery in patients with infective endocarditis and construction of a nomogram model

DUAN Yan-zi; LYU Xiang-ni

doi:10.11659/jjssx.01E026146

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Risk factors for prolonged ICU duration after surgery in patients with infective endocarditis and construction of a nomogram model

Clinical Research | 更新时间：2026-10-26

- Risk factors for prolonged ICU duration after surgery in patients with infective endocarditis and construction of a nomogram model
- JOURNAL OF REGIONAL ANATOMY AND OPERATIVE SURGERY Vol. 35, Issue 10, Pages: 901-905(2026)
- 作者机构：
  
  空军军医大学第一附属医院心血管外科，陕西西安 710032
- 作者简介：
- 基金信息：
- DOI：10.11659/jjssx.01E026146
  CLC： R542.4
- Received：23 January 2026，
  
  Revised：2026-09-18，
  
  Accepted：16 April 2026，
  
  Published：25 October 2026
- 稿件说明：
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段艳子,吕向妮.感染性心内膜炎患者术后ICU停留时间延长的影响因素及列线图模型构建[J].局解手术学杂志,2026,35(10):901-905.

DUAN Yan-zi,LYU Xiang-ni.Risk factors for prolonged ICU duration after surgery in patients with infective endocarditis and construction of a nomogram model[J].JOURNAL OF REGIONAL ANATOMY AND OPERATIVE SURGERY,2026,35(10):901-905.
段艳子,吕向妮.感染性心内膜炎患者术后ICU停留时间延长的影响因素及列线图模型构建[J].局解手术学杂志,2026,35(10):901-905. DOI： 10.11659/jjssx.01E026146.

DUAN Yan-zi,LYU Xiang-ni.Risk factors for prolonged ICU duration after surgery in patients with infective endocarditis and construction of a nomogram model[J].JOURNAL OF REGIONAL ANATOMY AND OPERATIVE SURGERY,2026,35(10):901-905. DOI： 10.11659/jjssx.01E026146.

摘要

目的

探讨感染性心内膜炎（IE）患者术后ICU停留时间延长的影响因素并构建列线图模型。

方法

回顾性纳入2023年2月至2025年2月于我院心血管外科进行手术治疗的IE患者210例，根据其术后ICU停留时间是否超过72 h分为非延长组（≤72 h，151例）和延长组（>72 h，59例）。采用Logistic回归分析IE患者术后ICU停留时间延长的独立危险因素，并根据筛选出的影响因素构建列线图模型，采用受试者工作特征曲线、校准曲线、决策曲线分析（DCA）评估预测模型的准确性。

结果

Logistic多因素结果显示：术前左室射血分数（LVEF）

60%、使用主动脉内球囊反搏泵（IABP）、机械通气时间

24 h、肌酐水平过高、栓塞是IE患者术后ICU停留时间延长的独立危险因素。列线图模型的曲线下面积（AUC）为0.985（95%

：0.965～1.000），敏感度为0.971，特异度为0.955。校准曲线的实际概率与预测概率有较高的一致性。DCA显示：该模型在预测IE患者术后ICU停留时间延长方面具有较高临床效能。

结论

术前LVEF<60%、使用IABP、机械通气时间>24 h、肌酐水平过高、栓塞是IE患者术后ICU停留时间延长的独立危险因素，基于这些因素构建的列线图模型的预测价值较高。

Abstract

Objective

To investigate the risk factors for prolonged ICU duration after surgery in patients with infective endocarditis （IE） and to construct a nomogram model.

Methods

A total of 210 patients with IE who underwent surgery in the Department of Cardiovascular Surgeryat our hospital from February 2023 to February 2025 were retrospectively included and divided into the non‑prolonged group （≤72 hours，151 cases） and the prolonged group （>72 hours，59 cases） based on whether their ICU duration exceeded 72 hours after surgery.Logistic regression analysis was performed to identify the independent risk factors for prolonged ICU duration after surgery in patients with IE. A nomogram model was constructed based on the identified risk factors， and the predictive accuracy of the model was evaluated by receiver operating characteristic curve， calibration curve， and decision curve analysis （DCA）.

Results

Multivariate Logistic regression analysis showed that preoperative left ventricular ejection fraction （LVEF）

60%， use of intra‑aortic balloon pump （IABP）， mechanical ventilation duration

24 hours， elevated creatinine level， and embolism were the independent risk factors for prolonged ICU duration after surgery in patients with IE.The area under the curve （AUC） of the nomogram model was 0.985 （95%

：0.965 to 1.000），with a sensitivity of 0.971 and a specificit

y of 0.955.The calibration curve showed high consistency between the predicted and actual probabilities.DCA indicated that the model had high clinical utility in predicting prolonged ICU duration after surgery in patients with IE.

Conclusion

Preoperative LVEF < 60%， use of IABP， mechanical ventilation duration > 24 hours， elevated creatinine level， and embolism were the independent risk factors for prolonged ICU duration after surgery in patients with IE， and the nomogram model constructed based on these factors demonstrated high predictive value.

关键词

Keywords

references

席常青，梁法禹，卫华，等 . 感染性心内膜炎延迟诊断的影响因素研究［J］. 中国现代医学杂志， 2023 ， 33 （ 10 ）： 55 - 58 . doi： 10.3969/j.issn.1005-8982.2023.10.010 http://dx.doi.org/10.3969/j.issn.1005-8982.2023.10.010 .

穆清，李志英，张景迪，等 . 南阳地区感染性心内膜炎患者的致病菌与临床特征研究［J］. 中国病原生物学杂志， 2024 ， 19 （ 6 ）： 675 - 679 . doi： 10.13350/j.cjpb.240611 http://dx.doi.org/10.13350/j.cjpb.240611 .

Huang JB ， Wen ZK ， Lu CC ， et al . Risk factors of prolonged intensive care unit stay following cardiac surgery for infective endocarditis ［J］. Medicine （Baltimore）， 2023 ， 102 （ 38 ）： e35128 . doi： 10.1097/MD.0000000000035128 http://dx.doi.org/10.1097/MD.0000000000035128 .

Zhang X ， Zhang W ， Lou H ， et al . Risk factors for prolonged intensive care unit stays in patients after cardiac surgery with cardiopulmonary bypass：a retrospective observational study ［J］. Int J Nurs Sci ， 2021 ， 8 （ 4 ）： 388 - 393 . doi： 10.1016/j.ijnss.2021.09.002 http://dx.doi.org/10.1016/j.ijnss.2021.09.002 .

Curran TF ， Sunkara B ， Leis A ， et al . Outcomes after prolonged ICU stays in postoperative cardiac surgery patients ［J］. Fed Pract ， 2022 ， 39 （ Suppl 5 ）： S6-S11c . doi： 10.12788/fp.0300 http://dx.doi.org/10.12788/fp.0300 .

Fowler VG ， Durack DT ， Selton-Suty C ， et al . The 2023 Duke-International society for cardiovascular infectious diseases criteria for infective endocarditis： updating the modified Duke criteria ［J］. Clin Infect Dis ， 2023 ， 77 （ 4 ）： 518 - 526 . doi： 10.1093/cid/ciad271 http://dx.doi.org/10.1093/cid/ciad271 .

Ris T ， Teixeira-Carvalho A ， Coelho RMP ， et al . Inflammatory biomarkers in infective endocarditis：machine learning to predict mortality ［J］. Clin Exp Immunol ， 2019 ， 196 （ 3 ）： 374 - 382 . doi： 10.1111/cei.13266 http://dx.doi.org/10.1111/cei.13266 .

Nishiguchi S ， Nishino K ， Kitagawa I ， et al . Factors associated with delayed diagnosis of infective endocarditis：a retrospective cohort study in a teaching hospital in Japan ［J］. Medicine （Baltimore）， 2020 ， 99 （ 30 ）： e21418 . doi： 10.1097/MD.0000000000021418 http://dx.doi.org/10.1097/MD.0000000000021418 .

林立金，柳叶茂，秦娟娟，等 . 1990-2030年全球和区域感染性心内膜炎的疾病负担及其归因危险因素的趋势和预测［J］. 中国医学科学杂志（英文版）， 2022 ， 37 （ 3 ）： 181 - 194 . doi： 10.24920/004118 http://dx.doi.org/10.24920/004118 .

Zeng X ， Liang Y ， Wang H ， et al . Detection of pathogens from venous or arterial blood of patients with left-sided infective endocarditis by metagenomic next-generation sequencing：a prospective study ［J］. Clin Chim Acta ， 2024 ， 552 ： 117698 . doi： 10.1016/j.cca.2023. 117698 http://dx.doi.org/10.1016/j.cca.2023.117698 .

Chobufo MD ， Atti V ， Vasudevan A ， et al . Trends in infective endocarditis mortality in the United States：1999 to 2020：a cause for alarm ［J］. J Am Heart Assoc ， 2023 ， 12 （ 24 ）： e031589 . doi： 10.1161/JAHA.123. 031589 http://dx.doi.org/10.1161/JAHA.123.031589 .

Honda Y ， Honma K ， Nishimura S ， et al . Predictors of postoperative physical functional decline at hospital discharge in elderly patients with prolonged intensive care unit stay after cardiac surgery ［J］. Heart Lung ， 2024 ， 64 ： 86 - 92 . doi： 10.1016/j.hrtlng.2023.11.014 http://dx.doi.org/10.1016/j.hrtlng.2023.11.014 .

Yesiler FI ， Akmatov N ， Nurumbetova O ， et al . Incidence of and risk factors for prolonged Intensive Care Unit Stay after open heart surgery among elderly patients ［J］. Cureus ， 2022 ， 14 （ 11 ）： e31602 . doi： 10.7759/cureus.31602 http://dx.doi.org/10.7759/cureus.31602 .

汤黎黎，黎学明，雷黎明，等 . 感染性心内膜炎患者外科术后发生ICU时间延长的危险因素［J］. 实用医学杂志， 2024 ， 40 （ 20 ）： 2854 - 2859 . doi： 10.3969/j.issn.1006-5725.2024.20.007 http://dx.doi.org/10.3969/j.issn.1006-5725.2024.20.007 .

赖小刚，徐殊，赵科研 . 白细胞介素-6联合乳酸在心脏瓣膜术后ICU停留时间延长的预测价值［J］. 中国实验诊断学， 2025 ， 29 （ 6 ）： 655 - 660 . doi： 10.3969/j.issn.1007-4287.2025.06.006 http://dx.doi.org/10.3969/j.issn.1007-4287.2025.06.006 .

Zhong J ， Luo JC ， Wang H ， et al . The transition and outcomes of perioperative low ejection fraction status in cardiac surgical patients ［J］. Rev Cardiovasc Med ， 2021 ， 22 （ 4 ）： 1721 - 1728 . doi： 10.31083/j.rcm2204180 http://dx.doi.org/10.31083/j.rcm2204180 .

Awan NI ， Jan A ， Rehman MU ， et al . The effect of ejection fraction on mortality in Coronary Artery Bypass Grafting （CABG） patients ［J］. Pak J Med Sci ， 2020 ， 36 （ 7 ）： 1454 - 1459 . doi： 10.12669/pjms.36. 7.3266 http://dx.doi.org/10.12669/pjms.36.7.3266 .

Leivaditis V ， Grapatsas K ， Papaporfyriou A ， et al . The perioperative use of levosimendan as a means of optimizing the surgical outcome in patients with severe heart insufficiency undergoing cardiac surgery ［J］. J Cardiovasc Dev Dis ， 2023 ， 10 （ 8 ）： 332 . doi： 10.3390/jcdd 10080332 http://dx.doi.org/10.3390/jcdd10080332 .

陈豫贤，于淑君，姜正明，等 . 202例感染性心内膜炎病原学特征及预后影响因素［J］. 中华医院感染学杂志， 2021 ， 31 （ 15 ）： 2287 - 2290 . doi： 10.11816/cn.ni.2021-203106 http://dx.doi.org/10.11816/cn.ni.2021-203106 .

刘妍，石秀梅，朱光发 . 发生栓塞事件的感染性心内膜炎患者临床特点及危险因素分析［J］. 心肺血管病杂志， 2022 ， 41 （ 11 ）： 1150 - 1154 . doi： 10.3969/j.issn.1007-5062.2022.11.006 http://dx.doi.org/10.3969/j.issn.1007-5062.2022.11.006 .

Tunc M ， Şahutoglu C ， Karaca N ， et al . Risk factors for prolonged intensive Care Unit Stay after open heart surgery in adults ［J］. Turk J Anaesthesiol Reanim ， 2018 ， 46 （ 4 ）： 283 - 291 . doi： 10.5152/TJAR. 2018.92244 http://dx.doi.org/10.5152/TJAR.2018.92244 .

Martins RS ， Waqar U ， Raza HA ， et al . Assessing risk factors for prolonged intensive care unit stay after surgery for adult congenital heart disease：a study from a lower-middle-income country ［J］. Cureus ， 2023 ， 15 （ 2 ）： e35606 . doi： 10.7759/cureus.35606 http://dx.doi.org/10.7759/cureus.35606 .

Luo Q ， Su Z ， Jia Y ， et al . Risk factors for prolonged mechanical ventilation after total cavopulmonary connection surgery：8 years of experience at fuwai hospital ［J］. J Cardiothorac Vasc Anesth ， 2020 ， 34 （ 4 ）： 940 - 948 . doi： 10.1053/j.jvca.2019.10.043 http://dx.doi.org/10.1053/j.jvca.2019.10.043 .

高榕，张瑶 . 急性心肌炎住院患者的临床特征及预后相关因素分析［J］. 中华心血管病杂志， 2024 ， 52 （ 10 ）： 1193 - 1199 . doi： 10.3760/cma.j.cn112148-20240827-00483 http://dx.doi.org/10.3760/cma.j.cn112148-20240827-00483 .

仲骏，郑吉莉，薛燕，等 . 心脏外科术后非计划性再入ICU病人院内死亡风险因素分析及护理对策［J］. 护理研究， 2021 ， 35 （ 13 ）： 2285 - 2290 . doi： 10.12102/j.issn.1009-6493.2021.13.005 http://dx.doi.org/10.12102/j.issn.1009-6493.2021.13.005 .

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