Front. Pharmacol.

Sec. Experimental Pharmacology and Drug Discovery

Volume 15 - 2024 | doi: 10.3389/fphar.2024.1486346

Provisionally accepted

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Objective: Intra-abdominal candidiasis (IAC) is difficult to predict in elderly septic patients with intra-abdominal infection (IAI). This study aimed to develop and validate a nomogram based on lymphocyte subtyping and clinical factors for the early and rapid prediction of IAC in elderly septic patients.: A prospective cohort study of 284 consecutive elderly patients diagnosed with sepsis and IAI was performed. We assessed the clinical characteristics and parameters of lymphocyte subtyping at the onset of IAI. A machine-learning random forest model was used to select important variables, and multivariate logistic regression was used to analyze the factors influencing IAC. A nomogram model was constructed, and the discrimination, calibration, and clinical effectiveness of the model were verified. Results: According to the results of the random forest and multivariate analyses, gastrointestinal perforation, renal replacement therapy (RRT), T-cell count, CD28+CD8+ T-cell count and CD38+CD8+ T-cell count were independent predictors of IAC. Using the above parameters to establish a nomogram, the area under the curve (AUC) values of the nomogram in the training and testing cohorts were 0.840 (95%CI 0.778-0.902) and 0.783 (95%CI 0.682-0.883), respectively. The AUC in the training cohort was greater than the Candida score [0.840 (95%CI 0.778-0.902) vs. 0.539 (95%CI 0.464-0.615), p

Keywords: intra-abdominal candidiasis, Elderly, Sepsis, Lymphocyte subtyping, risk stratification, machine learning, nomogram Clinical Trial Registration: chictr.org.cn, identifier ChiCTR2300069020

Received: 26 Aug 2024; Accepted: 29 Nov 2024.

Copyright: © 2024 . This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

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