{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,8]],"date-time":"2026-04-08T06:08:56Z","timestamp":1775628536211,"version":"3.50.1"},"reference-count":32,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,4,8]],"date-time":"2026-04-08T00:00:00Z","timestamp":1775606400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Public Health"],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>This study aimed to develop and validate a novel model for predicting mortality risk in cancer patients with carbapenem-resistant organism (CRO) infections.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Cancer patients with CRO infections in Henan Cancer Hospital between January 2022 and March 2024 were included in this retrospective study. LASSO regression was used to construct a novel model for predicting mortality in cancer patients with CRO infections. Receiver operating characteristic (ROC), decision curve analysis (DCA), and clinical impact curves (CIC) were used to assess the predictive ability and clinical utility of the prediction model.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      A total of 417 cancer patients with CRO infections were included in the study. Fourteen factors were selected, including sample source, radiotherapy, blood culture, exposure to antibiotics after susceptibility testing, lymphocyte-to-monocyte ratio (LMR), lymphocyte-to-monocyte ratio (LMR), total protein (TP), blood urea nitrogen (BUN), calcium (CA), C-reactive protein (CRP), triglyceride (TG), procalcitonin (PCT), prothrombin time (PT), and thrombin time (TT), which were found to be associated with 30-day mortality in cancer patients with CRO infections. The areas under the ROC curve for the prediction model were 0.815 (95% CI: 0.767\u20130.857) and 0.801 (95% CI: 0.716\u20130.871) for the primary cohort and validation cohort, respectively. The models demonstrated good predictive accuracy, with\n                      <jats:italic>p<\/jats:italic>\n                      -values 0.479 and 0.786 on the Hosmer\u2013Lemeshow test. DCA and CIC analyses confirmed the clinical utility of the prediction model.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Our model could be used as an effective individualized risk prediction tool for clinicians. It would provide personalized risk assessments for cancer patients with CRO infections.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fpubh.2026.1734259","type":"journal-article","created":{"date-parts":[[2026,4,8]],"date-time":"2026-04-08T05:32:05Z","timestamp":1775626325000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Development and validation of a novel model based on hematological biomarkers for predicting risk factors and outcomes in cancer patients with carbapenem-resistant organism infection"],"prefix":"10.3389","volume":"14","author":[{"given":"Bin","family":"Li","sequence":"first","affiliation":[{"name":"Department of Orthopedics, The First Affiliated Hospital of Zhengzhou University","place":["Zhengzhou, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xiaoyan","family":"Wen","sequence":"additional","affiliation":[{"name":"Central Sterilization Supply Department, The Guanghua Stomatological College of Sun Yat-sen University, Hospital of Stomatology, Sun Yat-sen University","place":["Guangzhou, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Min","family":"Jing","sequence":"additional","affiliation":[{"name":"Department of Clinical Laboratory, The Affiliated Cancer Hospital of Zhengzhou University & Henan Cancer Hospital","place":["Zhengzhou, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yuanye","family":"Qu","sequence":"additional","affiliation":[{"name":"Department of Clinical Laboratory, The Affiliated Cancer Hospital of Zhengzhou University & Henan Cancer Hospital","place":["Zhengzhou, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Junhua","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Clinical Laboratory, The Affiliated Cancer Hospital of Zhengzhou University & Henan Cancer Hospital","place":["Zhengzhou, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Qingxia","family":"Xu","sequence":"additional","affiliation":[{"name":"Department of Clinical Laboratory, The Affiliated Cancer Hospital of Zhengzhou University & Henan Cancer Hospital","place":["Zhengzhou, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shulin","family":"Chen","sequence":"additional","affiliation":[{"name":"State Key Laboratory of Oncology in South China, Guangdong Provincial Clinical Research Center for Cancer, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center","place":["Guangzhou, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ning","family":"Xue","sequence":"additional","affiliation":[{"name":"Department of Clinical Laboratory, The Affiliated Cancer Hospital of Zhengzhou University & Henan Cancer Hospital","place":["Zhengzhou, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2026,4,8]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"229","DOI":"10.3322\/caac.21834","article-title":"Global Cancer Statistics 2022: Globocan estimates of incidence and mortality worldwide for 36 cancers in 185 countries","volume":"74","author":"Bray","year":"2024","journal-title":"CA Cancer J Clin"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"2551","DOI":"10.1007\/s00210-023-02781-2","article-title":"Effects of chemotherapy on the immune system: implications for cancer treatment and patient outcomes","volume":"397","author":"Sharma","year":"2024","journal-title":"Naunyn Schmiedeberg's Arch Pharmacol"},{"key":"ref3","doi-asserted-by":"crossref","first-page":"260","DOI":"10.25270\/wnds\/2021.260262","article-title":"Surgical site infection in cancer patients","volume":"33","author":"Bolton","year":"2021","journal-title":"Wounds"},{"key":"ref4","doi-asserted-by":"publisher","DOI":"10.3390\/pathogens11101132","article-title":"Pseudomonas aeruginosa bloodstream infections in patients with cancer: differences between patients with hematological malignancies and solid tumors","volume":"11","author":"Royo-Cebrecos","year":"2022","journal-title":"Pathogens"},{"key":"ref5","doi-asserted-by":"publisher","first-page":"dlae052","DOI":"10.1093\/jacamr\/dlae052","article-title":"Antimicrobial resistance of clinical bacterial isolates in China: current status and trends","volume":"6","author":"Qin","year":"2024","journal-title":"JAC-Antimicrob Resist"},{"key":"ref6","doi-asserted-by":"publisher","first-page":"404","DOI":"10.1186\/s12879-020-05131-2","article-title":"Risk factors for and clinical outcomes of carbapenem non-susceptible gram negative Bacilli bacteremia in patients with acute myelogenous leukemia","volume":"20","author":"Shin","year":"2020","journal-title":"BMC Infect Dis"},{"key":"ref7","doi-asserted-by":"publisher","first-page":"201","DOI":"10.2147\/idr.s393932","article-title":"A visualized mortality prediction score model in hematological malignancies patients with carbapenem-resistant organisms bloodstream infection","volume":"16","author":"Qian","year":"2023","journal-title":"Infect Drug Resist"},{"key":"ref8","doi-asserted-by":"publisher","first-page":"1076","DOI":"10.1002\/ajh.24489","article-title":"Bloodstream infections caused by Klebsiella pneumoniae in onco-hematological patients: clinical impact of carbapenem resistance in a multicentre prospective survey","volume":"91","author":"Trecarichi","year":"2016","journal-title":"Am J Hematol"},{"key":"ref9","doi-asserted-by":"publisher","first-page":"4943","DOI":"10.2147\/IDR.S419064","article-title":"Clinical characteristics and prognosis of bloodstream infection with carbapenem-resistant Pseudomonas aeruginosa in patients with hematologic malignancies","volume":"16","author":"Yuan","year":"2023","journal-title":"Infect Drug Resist"},{"key":"ref10","doi-asserted-by":"publisher","first-page":"2901","DOI":"10.2147\/IDR.S359833","article-title":"The threat of carbapenem-resistant Gram-negative Bacteria in patients with hematological malignancies: unignorable respiratory non-fermentative Bacteria-derived bloodstream infections","volume":"15","author":"Lu","year":"2022","journal-title":"Infect Drug Resist"},{"key":"ref11","doi-asserted-by":"publisher","first-page":"29","DOI":"10.1186\/s13756-022-01073-3","article-title":"Establishment and validation of a nomogram to predict the in-hospital death risk of nosocomial infections in cancer patients","volume":"11","author":"Jiang","year":"2022","journal-title":"Antimicrob Resist Infect Control"},{"key":"ref12","doi-asserted-by":"publisher","first-page":"e0217024","DOI":"10.1128\/spectrum.02170-24","article-title":"Development and validation of a nomogram-based risk prediction model for carbapenem-resistant Klebsiella pneumoniae in hospitalized patients","volume":"13","author":"Xu","year":"2025","journal-title":"Microbiol Spectrum"},{"key":"ref13","doi-asserted-by":"publisher","first-page":"84","DOI":"10.1186\/s13756-024-01441-1","article-title":"Carbapenem-resistant enterobacterales sepsis following endoscopic retrograde cholangiopancreatography: risk factors for 30-day all-cause mortality and the development of a nomogram based on a retrospective cohort","volume":"13","author":"Zhang","year":"2024","journal-title":"Antimicrob Resist Infect Control"},{"key":"ref14","doi-asserted-by":"publisher","first-page":"852761","DOI":"10.3389\/fcimb.2022.852761","article-title":"A nomogram with six variables is useful to predict the risk of acquiring carbapenem-resistant microorganism infection in ICU patients","volume":"12","author":"Zhang","year":"2022","journal-title":"Front Cell Infect Microbiol"},{"key":"ref15","doi-asserted-by":"publisher","first-page":"2623","DOI":"10.2147\/JIR.S454117","article-title":"Correlations between acute coronary syndrome and novel inflammatory markers (systemic immune-inflammation index, systemic inflammation response index, and aggregate index of systemic inflammation) in patients with and without diabetes or prediabetes","volume":"17","author":"Tuzimek","year":"2024","journal-title":"J Inflamm Res"},{"key":"ref16","doi-asserted-by":"publisher","first-page":"296","DOI":"10.1016\/j.athoracsur.2017.01.085","article-title":"Clinical significance of prognostic nutritional index after surgical treatment in lung cancer","volume":"104","author":"Okada","year":"2017","journal-title":"Ann Thorac Surg"},{"key":"ref17","doi-asserted-by":"publisher","first-page":"6261","DOI":"10.3748\/wjg.v23.i34.6261","article-title":"Systemic immune-inflammation index for predicting prognosis of colorectal cancer","volume":"23","author":"Chen","year":"2017","journal-title":"World J Gastroenterol"},{"key":"ref18","doi-asserted-by":"publisher","first-page":"531","DOI":"10.1016\/s0749-0704(05)70198-6","article-title":"Infectious morbidity in critically ill patients with cancer","volume":"17","author":"Safdar","year":"2001","journal-title":"Crit Care Clin"},{"key":"ref19","doi-asserted-by":"publisher","first-page":"298","DOI":"10.1080\/21505594.2016.1141161","article-title":"Bloodstream infections in patients with solid tumors","volume":"7","author":"Gudiol","year":"2016","journal-title":"Virulence"},{"key":"ref20","doi-asserted-by":"publisher","first-page":"e57320","DOI":"10.1371\/journal.pone.0057320","article-title":"The ratio of monocytes to lymphocytes in peripheral blood correlates with increased susceptibility to clinical malaria in Kenyan children","volume":"8","author":"Warimwe","year":"2013","journal-title":"PLoS One"},{"key":"ref21","doi-asserted-by":"publisher","first-page":"299","DOI":"10.1007\/s15010-016-0972-1","article-title":"Role of neutrophil to lymphocyte and monocyte to lymphocyte ratios in the diagnosis of bacterial infection in patients with fever","volume":"45","author":"Naess","year":"2017","journal-title":"Infection"},{"key":"ref22","first-page":"S161","article-title":"Inflamatory indexes predictors of complicated acute apendicitis in children","volume":"61","author":"Ortiz-Ley","year":"2023","journal-title":"Rev Med Inst Mex Seguro Soc"},{"key":"ref23","doi-asserted-by":"publisher","first-page":"2209","DOI":"10.2147\/jir.s409871","article-title":"Neutrophil\/lymphocyte ratio (NLR) and lymphocyte\/monocyte ratio (LMR) - risk of death inflammatory biomarkers in patients with COVID-19","volume":"16","author":"Dymicka-Piekarska","year":"2023","journal-title":"J Inflamm Res"},{"key":"ref24","doi-asserted-by":"publisher","first-page":"123","DOI":"10.3233\/ch-189111","article-title":"Blood urea nitrogen (BUN) independently predicts mortality in critically ill patients admitted to ICU: a multicenter study","volume":"69","author":"Wernly","year":"2018","journal-title":"Clin Hemorheol Microcirc"},{"key":"ref25","doi-asserted-by":"publisher","first-page":"11653","DOI":"10.21037\/apm-21-2937","article-title":"Association between blood urea nitrogen and 30-day mortality in patients with sepsis: a retrospective analysis","volume":"10","author":"Li","year":"2021","journal-title":"Ann Palliat Med"},{"key":"ref26","doi-asserted-by":"publisher","first-page":"943","DOI":"10.2147\/ndt.s354447","article-title":"Serum calcium levels and in-hospital infection risk in patients with acute ischemic stroke","volume":"18","author":"Chen","year":"2022","journal-title":"Neuropsychiatr Dis Treat"},{"key":"ref27","doi-asserted-by":"publisher","first-page":"2520695","DOI":"10.1155\/2022\/2520695","article-title":"The positive and negative effects of calcium supplementation on mortality in septic ICU patients depend on disease severity: a retrospective study from the mimic-iii","volume":"2022","author":"He","year":"2022","journal-title":"Crit Care Res Prac"},{"key":"ref28","doi-asserted-by":"publisher","first-page":"63","DOI":"10.1016\/j.mito.2021.04.009","article-title":"The role of mitophagy in pulmonary sepsis","volume":"59","author":"Mohsin","year":"2021","journal-title":"Mitochondrion"},{"key":"ref29","doi-asserted-by":"publisher","first-page":"2191","DOI":"10.1080\/03007995.2024.2425383","article-title":"Utility of C-reactive protein and procalcitonin in community-acquired pneumonia in children: a narrative review","volume":"40","author":"Omaggio","year":"2024","journal-title":"Curr Med Res Opin"},{"key":"ref30","doi-asserted-by":"publisher","first-page":"103","DOI":"10.1186\/s12941-023-00653-4","article-title":"PCT, IL-6, and IL-10 facilitate early diagnosis and pathogen classifications in bloodstream infection","volume":"22","author":"Yang","year":"2023","journal-title":"Ann Clin Microbiol Antimicrob"},{"key":"ref31","doi-asserted-by":"publisher","first-page":"1563170","DOI":"10.3389\/fcimb.2025.1563170","article-title":"Clinical application of combined CRP and PCT detection in diagnosing and prognosing fracture-related infections","volume":"15","author":"Liu","year":"2025","journal-title":"Front Cell Infect Microbiol"},{"key":"ref32","doi-asserted-by":"publisher","first-page":"e939203","DOI":"10.12659\/MSM.939203","article-title":"Effect of Cefoperazone\/Sulbactam on blood coagulation function in infected emergency department patients and the necessity of vitamin K1 (Vk1) preventive intervention: a single-center, retrospective analysis","volume":"29","author":"Shao","year":"2023","journal-title":"Med Sci Monit"}],"container-title":["Frontiers in Public Health"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fpubh.2026.1734259\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,8]],"date-time":"2026-04-08T05:32:05Z","timestamp":1775626325000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fpubh.2026.1734259\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,4,8]]},"references-count":32,"alternative-id":["10.3389\/fpubh.2026.1734259"],"URL":"https:\/\/doi.org\/10.3389\/fpubh.2026.1734259","relation":{},"ISSN":["2296-2565"],"issn-type":[{"value":"2296-2565","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,4,8]]},"article-number":"1734259"}}