摘要
目的运用Logistic回归模型和ROC曲线探讨神经外科医院感染发生危险因素和分析预测价值。方法回顾性调查收集某三甲医院神经外一科2017年1月1日-2018年12月31日4 205例住院患者病历资料,采用Logistic回归分析医院感染危险因素并进行预测,应用ROC曲线进行预测价值评价。结果神经外一科4 205例住院患者发生医院感染例数127例,感染率为3. 02%;感染部位主要以下呼吸道感染为主(41. 73%);单因素研究结果显示,年龄、手术类型、留置尿管、围手术期输血、气管插管/切开5个因素与神经外一科住院患者医院感染的发生相关(P <0. 05)。多因素Logistic回归结果显示,年龄≥60岁、急诊手术、围手术期输血、气管插管/切开是神经外科住院患者感染的主要独立危险因素;联合预测因子的AUC值为0. 852,95%CI为0. 754~1. 000,其预测价值均优于各单一变量的预测价值。结论神经外科住院患者易发生医院感染,应重点关注年龄≥60岁、急诊手术、围手术期输血、气管插管/切开的患者,并有针对性地制定相关防控措施,以降低医院感染发生。
Objective To explore the risk factors of nosocomial infection in neurosurgery hospital using Logistic regression model and ROC curve,and to analyze the predictive value. Methods A retrospective survey was conducted to collect the medical records of 4 205 inpatients in the first department of neurosurgery in a level A tertiary hospital from January 1,2017 to December 31,2018. Logistic regression was used to analyze and predict the risk factors of nosocomial infection,and the ROC curve was used to evaluate the value of prediction. Results There were 127 cases of nosocomial infection among4 205 inpatients in the first department of neurosurgery,and the infection rate was 3. 02%. The main infection sites were lower respiratory tract infection( 41. 73%). The results of univariate analysis showed that five factors such as age,type of operation,indwelling urinary catheter,perioperative blood transfusion,endotracheal intubation/incision were related to the occurrence of nosocomial infections in inpatients in the department of neurology( P < 0. 05). Multivariate Logistic regression results showed that age ≥60 years old,emergency surgery,perioperative blood transfusion,and endotracheal intubation/incision were the main independent risk factors for infection in neurosurgical inpatients. The AUC value of the combined predictor PRE-1 was 0. 852 and the 95% CI was 0. 754-1. 000,and both of them were better than the prediction value of each single variable. Conclusion Inpatients in neurosurgery department are prone to nosocomial infections. We should pay attention to patients aged ≥60 years old who have emergency surgery,perioperative blood transfusion and endotracheal intubation/incision,and formulate relevant prevention and control measures to reduce the incidence of nosocomial infection.
作者
胡新
HU Xin(Shengjing Hospital Affiliated to China Medical University!Shenyang Liaoning 110000,China)
出处
《中国消毒学杂志》
CAS
2020年第8期591-594,共4页
Chinese Journal of Disinfection
