| Abstract Objective: To construct a nomogram prediction model for respiratory failure in elderly patients with chronic obstructive pulmonary disease (COPD) based on the levels of interleukin-32 (IL-32), soluble CD40 ligand (sCD40L) and α1-antitrypsin (α1-AT), so as to guide clinical prevention and treatment. Methods: A total of 200 elderly patients with COPD were enrolled and divided into the respiratory failure group (60 cases) and non-respiratory failure group (140 cases) according to the occurrence of respiratory failure. The influencing factors (levels of IL-32, sCD40L and α1-AT) for respiratory failure in elderly COPD patients were analyzed, the nomogram model was established, and internal validation was performed. Results: Respiratory failure occurred in 60 patients (30.00%). The proportions of age, annual acute exacerbation frequency ≥3 times, dyspnea, nocturnal awakening, smoking history, nosocomial infection, hypoalbuminemia, long-term use of inhaled glucocorticoids, and serum levels of IL-32, sCD40L and α1-AT were higher than those in the non-respiratory failure group (all P< 0.05). Age, nosocomial infection, annual acute exacerbation frequency, hypoalbuminemia, and serum levels of IL-32, sCD40L and α1-AT were independent influencing factors for respiratory failure in elderly COPD patients (all P< 0.05). Receiver operating characteristic (ROC) curve, calibration curve and decision curve analysis (DCA) demonstrated that the model had high accuracy, good predictive performance and clinical utility. Conclusion: The incidence of respiratory failure is relatively high in elderly COPD patients. Its independent risk factors include age, nosocomial infection, annual acute exacerbation frequency, hypoalbuminemia, and serum levels of IL-32, sCD40L and α1-AT. The nomogram prediction model constructed based on these factors shows favorable calibration and high predictive value. |
