Abstract
BACKGROUND: Patients with heart valve disease (VHD) combined with pulmonary hypertension (PH) have a higher risk for hospital-acquired pneumonia. We aimed to analyze the risk factors and construct a valid nomogram model for predicting hospital-acquired pneumonia among those patients. METHODS: Patients with VHD combined with PH who underwent heart valve replacement were collected. The perioperative risk factors for hospital-acquired pneumonia were analyzed by univariable and logistic regression, and then a nomogram prediction model was constructed and validated. RESULTS: A total of 377 patients were included, and 81 cases developed postoperative hospital-acquired pneumonia, with an incidence of 21.49%. The results of multifactorial analysis showed that preoperative anemia, ASA score >grade III, duration of surgery ≥313 min, duration of endotracheal intubation ≥3 d, duration of indwelling gastric tube ≥1 d, and bioprosthetic valve usage were the risk factors for the occurrence of postoperative hospital-acquired pneumonia (P < 0.05). The model validation results showed that patients judged to be at high risk of hospital-acquired pneumonia are consistent with the actual situation, indicating that the model has good predictive efficacy. CONCLUSIONS: The constructed six-variable nomogram prediction model has satisfying efficacy in predicting hospital-acquired pneumonia after valve replacement in patients with VHD combined with PH. It is significant for early identification and future quality improvement to reduce the risk of hospital-acquired pneumonia.