| Objective To explore the key influencing factors for poor prognosis in patients with acute blunt abdominal trauma and to construct and validate a nomogram prediction model. Methods A total of 297patients with acute blunt abdominal trauma admitted to Jingmen People's Hospital from August 2020 to August 2024 were retrospectively included and divided into a death group (n=33) and a survival group (n =264) based on in-hospital mortality. Variables were screened using Lasso regression, and independent risk factors were identified by multivariate logistic regression to construct a nomogram model. Internal validation was performed via the bootstrap method (1 000 resamples). Model performance was evaluated using calibration curves, receiver operating characteristic (ROC) curves, and decision curve analysis (DCA). Results Univariate analysis showed that the death group had significantly higher values than the survival group in terms of age, diabetes history, time from injury to medical consultation, Injury Severity Score (ISS), grade of liver/spleen injury (AAST-OIS), proportion of hemorrhagic shock, and blood lactate level (all P<0.05). Multivariate logistic regression analysis identified ISS score ≥16, liver AAST-OIS grade ≥IV, hemorrhagic shock, blood lactate ≥4 mmol/L, and time from injury to medical care ≥2 h as independent risk factors for poor prognosis (all P<0.05). The prediction model constructed based on these factors demonstrated good discrimination (AUC=0.874), excellent calibration (C-index=0.874), and clinical utility as indicated by DCA. Conclusion The nomogram model based on risk factors including ISS score, liver AAST-OIS grade, hemorrhagic shock, elevated blood lactate, and prolonged time from injury to medical care can effectively predict the risk of poor prognosis, providing a quantitative tool for clinical stratified management. |
