{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,4]],"date-time":"2025-12-04T23:18:57Z","timestamp":1764890337508,"version":"3.46.0"},"reference-count":31,"publisher":"BMJ","issue":"10","license":[{"start":{"date-parts":[[2025,10,24]],"date-time":"2025-10-24T00:00:00Z","timestamp":1761264000000},"content-version":"unspecified","delay-in-days":23,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"name":"Hebei Natural Science Foundation\uff0cChina","award":["H2023206071"],"award-info":[{"award-number":["H2023206071"]}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2025,10,6]]},"published-print":{"date-parts":[[2025,10]]},"abstract":"<jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>To develop and validate a predictive model for assessing in-hospital mortality in patients with intra-abdominal sepsis (IAS), a leading cause of sepsis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>Secondary analysis of two retrospective critical care databases.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting<\/jats:title>\n                    <jats:p>Data extracted from the Intensive Care Medicine Information Marketplace IV (MIMIC-IV) and the eICU Collaborative Research Database.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Participants<\/jats:title>\n                    <jats:p>Patients with IAS from MIMIC-IV (2008\u20132019; 1300 patients, 264 deaths) for model training and internal validation, and eICU (2014\u20132015; 149 patients, 33 deaths) for external validation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Interventions<\/jats:title>\n                    <jats:p>Clinical data were used for constructing a predictive model. Variable selection was performed using least absolute shrinkage and selection operator regression, followed by model development with multivariable logistic regression. The model was visualised as a nomogram.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Primary and secondary outcome measures<\/jats:title>\n                    <jats:p>The primary outcome was in-hospital mortality. Secondary outcomes were model performance metrics, including the area under the receiver operating characteristic curve (AUC), calibration curves, decision curve analysis and clinical impact curves.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Six predictors (lactate, age, activated partial thromboplastin time, blood urea nitrogen, total bilirubin and platelets) were identified. The predictive model showed good performance with an AUC of 0.795 (95% CI 0.758 to 0.831) in the training set (n=910) and 0.846 (95% CI 0.772 to 0.919) in the external validation set (n=149).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>A robust predictive model was developed to estimate the risk of in-hospital mortality in patients with IAS. This tool may assist clinicians in enhancing patient management and decision-making.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjopen-2025-102971","type":"journal-article","created":{"date-parts":[[2025,10,24]],"date-time":"2025-10-24T07:35:44Z","timestamp":1761291344000},"page":"e102971","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Development and validation of a prediction model for in-hospital mortality in patients with intra-abdominal sepsis: a dual-database study using MIMIC-IV and eICU databases"],"prefix":"10.1136","volume":"15","author":[{"given":"Jianjun","family":"Zhang","sequence":"first","affiliation":[{"name":"Department of Intensive Care Unit, Hebei Medical University Fourth Aliated Hospital and Hebei Provincial Tumor Hospital, Shijiazhuang, China"},{"name":"Department of Intensive Care Unit, Hengshui People\u2019s Hospital, Hengshui, Hebei, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yuhong","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Intensive Care Unit, Hebei Medical University Fourth Aliated Hospital and Hebei Provincial Tumor Hospital, Shijiazhuang, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Cong-cong","family":"Zhao","sequence":"additional","affiliation":[{"name":"Department of Intensive Care Unit, Hebei Medical University Fourth Aliated Hospital and Hebei Provincial Tumor Hospital, Shijiazhuang, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jinrong","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Intensive Care Unit, Hengshui People\u2019s Hospital, Hengshui, Hebei, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1404-5691","authenticated-orcid":false,"given":"Zhen-jie","family":"Hu","sequence":"additional","affiliation":[{"name":"Department of Intensive Care Unit, Hebei Medical University Fourth Aliated Hospital and Hebei Provincial Tumor Hospital, Shijiazhuang, China"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2025,10,23]]},"reference":[{"key":"2025120415081868000_15.10.e102971.1","doi-asserted-by":"publisher","DOI":"10.1097\/ccm.0000000000005337"},{"key":"2025120415081868000_15.10.e102971.2","doi-asserted-by":"crossref","first-page":"91","DOI":"10.2478\/jtim-2020-0014","article-title":"Detection of early cytokine storm in patients with septic shock after abdominal surgery","volume":"8","author":"Chao","year":"2020","journal-title":"J Transl Int Med"},{"key":"2025120415081868000_15.10.e102971.3","doi-asserted-by":"crossref","first-page":"1703","DOI":"10.1007\/s00134-019-05819-3","article-title":"Epidemiology of intra-abdominal infection and sepsis in critically ill patients: \u201cAbSeS\u201d, a multinational observational cohort study and ESICM Trials Group Project","volume":"45","author":"Blot","year":"2019","journal-title":"Intensive Care Med"},{"key":"2025120415081868000_15.10.e102971.4","doi-asserted-by":"publisher","DOI":"10.1186\/s13017-021-00387-8"},{"key":"2025120415081868000_15.10.e102971.5","doi-asserted-by":"crossref","unstructured":"Xue G , Liang H , Ye J , et al . 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