Purpose To identify risk factors for prolonged mechanical ventilation (PMV) after liver transplantation (LT) and to develop and internally validate a predictive nomogram.Methods A multicenter retrospective cohort of 746 LT recipients (January 2015-June 2023) was randomly split 7:3 into training (n = 522) and validation (n = 224) sets. We conducted univariate and multivariate logistic regression to identify factors linked to PMV. A risk nomogram was created based on the multivariate analysis, and its performance was evaluated for calibration, discrimination, and clinical utility, with internal validation using the Validation Set data.Results The incidence of PMV was 21.6%. Multivariate analysis identified five independent predictors of PMV: ASA scores >= 3, mechanical ventilation before LT, MELD score, albumin levels, and anhepatic phase. The nomogram developed from these predictors showed a concordance index (C-index) of 0.780 (95% CI, 0.734-0.827) and demonstrated good calibration. After internal validation, the model maintained a C-index of 0.731 (95% CI, 0.653-0.810). Decision curve analysis and clinical impact curve confirmed the nomogram's effectiveness.Conclusion The nomogram enables individualized PMV risk estimation in LT recipients and may guide early intervention and resource allocation.
[1]Army Med Univ, Affiliated Hosp 1, Dept Hepatobiliary Surg, Chongqing, Peoples R China.
[2]Sichuan Acad Med Sci & Sichuan Prov Peoples Hosp, Dept Hepatobiliary Surg, Chengdu, Peoples R China.
[3]Shandong First Med Univ, Liaocheng Peoples Hosp, Dept Organ Transplantat Surg, Liaocheng, Peoples R China.
[4]Shandong First Med Univ, Affiliated Liaocheng Hosp, Dept Organ Transplantat Surg, Liaocheng, Peoples R China.
[5]Shanghai Jiao Tong Univ, Affiliated Ruijin Hosp, Dept Gen Surg, Shanghai, Peoples R China.
[6]Hyg Co 65529 Troops PLA, Liaoyang, Peoples R China.
(8.0+极速模式)