摘要
目的分析四肢犬咬伤患者伤口感染影响因素,构建预测模型。方法回顾性分析2018年10月至2022年10月郑州大学第五附属医院急诊科收治的288例四肢犬咬伤患者的临床资料,分析感染者病原菌的分布情况,采用多因素logistic回归分析四肢犬咬伤患者伤口感染的影响因素,并构建风险预测模型,采用H-L检验预测模型拟合度,绘制ROC曲线分析模型的预测价值。结果288例患者中,44例出现伤口感染,感染率为15.28%。感染患者伤口分泌物培养分离45株菌株,以金黄色葡萄球菌为主。多因素logistic回归分析显示,年龄≥60岁、糖尿病、受伤至清创时间≥6 h是四肢犬咬伤患者伤口感染的危险因素,白蛋白≥35 g/L为保护因素(P<0.05)。构建四肢犬咬伤患者伤口感染预测模型,采用H-L检验方程拟合优度,拟合优度良好(P=0.495),计算患者的预测概率,并绘制ROC曲线,曲线下面积为0.761,约登指数为0.459,敏感度为75.00%,特异度为70.90%。结论四肢犬咬伤患者伤口感染发生率较高,年龄、糖尿病、受伤至清创的时间、白蛋白为伤口感染的影响因素,构建的预测模型对伤口感染的预测能效较好。
Objective To analyze the influencing factors of wound infection in patients with dog biting limbs and build a prediction model.Methods The clinical data of 288 patients with dog biting limbs treated in the Department of Emergency,the Fifth Affiliated Hospital of Zhengzhou University from October 2018 to October 2022 were retrospectively analyzed.The distribution of pathogenic bacteria in infected patients was analyzed,and the influencing factors of wound infection in patients with dog biting limbs were analyzed by multi-factor logistic regression.The risk prediction model was constructed,the fit degree of the prediction model was tested by H-L test,and the predictive value of the model was analyzed by ROC curve.Results Among 288 patients,44 had wound infection(15.28%).Forty-five strains were isolated from infected patients,and Staphylococcus aureus was the main strain.Multivariate logistic regression analysis showed that age≥60 years old,diabetes mellitus,time from injury to debridement≥6 h were the risk factors for wound infection in the patients with dog bite injuries,and albumin≥35 g/L was the protective factor(P<0.05).The prediction model of wound infection in patients with dog biting limbs was constructed,H-L test equation was used to test the goodness of fit,and the goodness of fit was good(P=0.495).The prediction probability of patients was calculated,and ROC curve was drawn.The area under the curve was 0.761,Youden index was 0.459,sensitivity was 75.00%,and specificity was 70.90%.Conclusion The incidence of wound infection in patients with dog biting limbs is higher.Age,diabetes,time from injury to debridement and albumin are the influencing factors of wound infection.The established prediction model has good energy efficiency in predicting wound infection.
作者
靳嘉琪
伍静
罗坤
潘德强
JIN Jiaqi;WU Jing;LUO Kun;PAN Deqiang(Department of Emergency,the Fifth Affiliated Hospital of Zhengzhou University,Henan Province,Zhengzhou 450052,China)
出处
《中国当代医药》
CAS
2024年第3期54-57,共4页
China Modern Medicine
基金
河南省医学科技攻关计划项目(LHGJ20200481)。
关键词
犬咬伤
伤口感染
影响因素
预测模型
Dog bite
Wound infection
Influencing factors
Prediction model
