Table 4.
Stepwise multivariate analysis of echocardiographic, LUS, and clinical scores for prediction of clinical events
| Variable | Model with SOFA | Model with MEWS | Model with clinical parameters∗ | Simple model with SOFA | Simple model with MEWS | Simple model with clinical parameters∗ |
|---|---|---|---|---|---|---|
| Mortality | ||||||
| TAPSE | 3.38 (1.43 to 7.97) | 2.22 (1.01 to 5.94) | 8.45 (1.98 to 36.05) | |||
| LVEF | 0.83 (0.29 to 2.32) | 0.43 (0.13 to 1.49) | 0.79 (0.19 to 3.32) | |||
| SVI | 2.58 (1.01 to 6.56) | 2.14 (0.81 to 5.69) | 5.13 (1.57 to 16.82) | |||
| LUS | 1.78 (0.69 to 4.56) | 1.42 (0.60 to 3.6) | 0.7 (0.18 to 2.72) | 1.68 (0.72 to 3.9) | 1.34 (0.56 to 3.2) | 1.26 (0.5 to 3.2) |
| “Super-simple” echocardiographic risk score | 1.28 (1.04 to 1.57) | 1.15 (0.97 to 1.45) | 1.24 (0.99 to 1.6) | |||
| SOFA | 1.1 (1.001 to 1.22) | 1.14 (1.03 to 1.25) | ||||
| MEWS | 1.26 (1.12 to 1.41) | 1.22 (1.10 to 1.36) | ||||
| AUC for score or clinical alone | 0.76 | 0.79 | 0.86 | 0.76 | 0.79 | 0.86 |
| AUC for combined model | 0.80 | 0.82 | 0.9 | 0.78 | 0.80 | 0.88 |
| AIC for score or clinical alone | 217 | 185 | 143 | 217 | 185 | 143 |
| AIC for combined model | 214 | 183 | 134 | 215 | 184 | 139 |
| IDI | 0.10 (0.02 to 0.2), P = .006 | 0.07 (0.004 to 0.16), P = .02 | 0.19 (0.06 to 0.3), P = .009 | 0.18 (0.05 to 0.323), P = .004 | 0.09 (0.026 to 0.19), P = .003 | 0.07 (0.004 to 0.16), P = .004 |
| NRI | 0.5 (0.3 to 0.7), P = .009 | 0.48 (0.05 to 0.6), P = .02 | 0.5 (0.13 to 0.7), P = .02 | 0.57 (0.36 to 0.75), P = .005 | 0.44 (−0.04 to 0.68), P = .08 | 0.58 (0.05 to 0.68), P = .02 |
| Log likelihood difference | χ2 = 11.1, P = .001 | χ2 = 6.51, P = .01 | χ2 = 17.7, P < .001 | χ2 = 14.3, P < .001 | χ2 = 6.99, P = .0008 | χ2 = 19.0, P < .001 |
| Composite event | ||||||
| TAPSE | 1.55 (0.68 to 3.54) | 1.02 (1.01 to 2.54) | 1.68 (0.47 to 5.97) | |||
| LVEF | 0.86 (0.34 to 2.19) | 0.44 (0.15 to 1.31) | 1.24 (0.35 to 4.47) | |||
| SVI | 2.49 (1.14 to 5.42) | 2.18 (1.001 to 4.92) | 4.05 (1.68 to 9.7) | |||
| LUS | 2.17 (1.07 to 4.42) | 1.28 (0.57 to 2.84) | 2.57 (1.003 to 6.7) | 1.87 (0.86 to 4.3) | 1.47 (0.7 to 3.3) | 1.56 (0.68 to 3.6) |
| Simple heart score | 3.15 (1.25 to 7.7) | 1.09 (0.88 to 1.32) | 1.19 (1.0002 to 1.51) | |||
| SOFA | 1.18 (1.1 to 1.27) | 1.24 (1.04 to 1.46) | ||||
| MEWS | 1.33 (1.19 to 1.46) | 1.29 (1.17 to 1.42) | ||||
| AUC for score or clinical alone | 0.83 | 0.83 | 0.75 | 0.83 | 0.83 | 0.75 |
| AUC for combined model | 0.85 | 0.85 | 0.80 | 0.85 | 0.85 | 0.81 |
| AIC for score or clinical alone | 280 | 292 | 201 | 280 | 292 | 201 |
| AIC for combined model | 277 | 230 | 193 | 276 | 256 | 194 |
| IDI | 0.06 (0.002 to 0.16), P = .03 | 0.03 (−0.002 to 0.12), P = .07 | 0.11 (0.025 to 0.23), P = .007 | 0.11 (0.02 to 0.23), P = .02 | 0.03 (−0.003 to 0.13), P = .10 | 0.14 (0.04 to 0.25), P = .005 |
| NRI | 0.4 (0.11 to 0.62), P = .02 | 0.4 (−0.07 to 0.6), P = .07 | 0.46 (0.05 to 0.62), P = .03 | 0.4 (0.2 to 0.6), P = .02 | 0.4 (−0.3 to 0.7), P = .17 | 0.43 (0.04 to 0.66), P = .05 |
| Log likelihood difference | χ2 = 6.96, P = .008 | χ2 = 4.24, P = .03 | χ2 = 14.3, P < .001 | χ2 = 11.6, P = .001 | χ2 = 2.82, P = .09 | χ2 = 18.7, P < .001 |
AIC, Akaike information criterion; AUC, area under the receiver operating characteristic curve; IDI, integrated discrimination improvement; NRI, net reclassification improvement.
∗
Clinical parameters: age, gender, systolic blood pressure, heart rate, oxygen saturation, and baseline troponin, d-dimer, and brain natriuretic peptide levels.