Prediction quality of patients’ composited outcomes of interest and how much variations on the outcomes explained by the patients’ sodium levels
1 Internal Medicine, Royal Medical Services, Amman, Jordan.
2 Nephrologist, Royal Medical Services, Amman, Jordan.
Research Article
World Journal of Biology Pharmacy and Health Sciences, 2024, 18(01), 136–141.
Article DOI: 10.30574/wjbphs.2024.18.1.0174
Publication history:
Received on 1 April 2024; revised on 09 April 2024; accepted on 10 April 2024
Abstract:
Background: Hypernatremia can be caused by medications, glucose/urea-related hyperosmolarity, overdiuresis, compartmental fluid distribution imbalances, iatrogenic hypertonic saline excess, renal concentrating performance defects, overdiuresis, and hypermetabolic states. Patients who are in critical condition, encompassing ailments of the heart, liver, lungs, brain, and kidneys, frequently manifest hyponatremia (sodium < 135 mEq/L). Similar to hypernatremia, hyponatremia signifies the severity of the illness and a bleak prognosis. Hyponatremia is less lethal than central pontine myelinolysis, which overcorrects sodium concentrations urgently.
Aim: The objective of this research endeavour was to investigate the strength of correlations, the extent to which the independent variables account for the overall variability in the dependent variable, and the accuracy of the dependent variable's predictions. In addition, the purpose of this test was to extract the coefficients required to present the Binary Logistic Regression models that were investigated.
Methods: Between May 2018 and May 2021, this study examined two Na-based prognosticators for overall mortality in critically ill patients admitted to the King Hussein Medical Centre. An investigation was conducted on 2155 cases utilising Receiver Operating Characteristic (ROC) and Sensitivity Indices Test analyses to ascertain the most effective cut-off points, specificities, sensitivity, predictive values, likelihood ratios, Youden and accuracy indices, and mortality rates. The research discovered that serial termination points with lower values suggested more robust evidence for a positive actual state, whereas higher values suggested less robust evidence for a negative actual state. A Binary Logistic Regression (BLgR) test was performed to examine correlations, the extent of total variations in the dependent variable, and the accuracy of the prediction for each Na-related mortality prognosticator in relation to overall mortality. The analysis was conducted utilising version 25 of SPSS for Windows.
Results: The research revealed that the AUROC for cNa was considerably greater in magnitude compared to its prognosticator that is genealogically related to Na. 129.35 mEq/l and 131.05 mEq/l were the optimal cut-off points, TPRs, TNRs, PPVs, NLRs, YIs, and AIs for the two comparative Na investigated statutes. The BLgR models were developed in order to simulate the relationship between the corrected and measured Na levels of patients and their overall mortality rate. For critically ill patients, the probabilities of overall mortality at the optimal cutoff operating Na levels were 79.59 and 81.62 percent, respectively.
Keywords:
Hospitalized patients’ overall risk; Natraemia statuses; Prediction Quality; Variations on the Outcomes
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