Construction and validation of a risk prediction model for early ventilator-induced diaphragm dysfunction in mechanically ventilated patients

The study examined early ventilator-induced diaphragm dysfunction (VIDD) in 470 mechanically ventilated patients in an intensive care unit. VIDD is diagnosed using diaphragm ultrasound and occurs within the first 24 hours of mechanical ventilation. The incidence of VIDD in the modeling group was 48.78% (160 of 328 patients). Identified independent risk factors were complicated sepsis, controlled mechanical ventilation mode, Richmond agitation-sedation scale score ≤ −4, APACHE II score >20, and complicated intra-abdominal hypertension (IAP ≥ 16 mmHg). The constructed nomogram model achieved an area under the ROC curve (AUC) of 0.820 in the modeling group and 0.816 in the validation group, indicating excellent discriminative ability and good external stability. The model demonstrates a high degree of agreement between predicted and actual values and has a wide range of clinically beneficial thresholds.