摘要
目的 分析泌尿外科老年住院患者院内感染的危险因素,构建泌尿外科老年住院患者院内感染的风险预测模型,并对其效能进行验证。方法 选取成都市第三人民医院泌尿外科2022年1~12月老年住院患者1 050例为研究对象,按照患者医院感染发生情况,分为感染患者(研究组)45例和非感染患者(对照组)1 005例。采用单因素和多因素Logistic法,筛选泌尿外科老年住院患者院内感染的危险因素,进而构建老年住院患者院内感染的风险预测模型。采用Hosmer and Lemeshow进行风险预测模型的拟合优度检验,绘制ROC曲线,评价风险预测模型的预测价值。结果 年龄>75岁、住院时间≥15 d、手术治疗、使用呼吸机辅助通气和留置导尿管是泌尿外科老年住院患者院感发生的危险因素;预测老年住院患者院内感染发生的概率模型:P=1/[1+exp(6.055-0.969X1-2.802X2-1.904X4-1.169X5-2.120X6)];ROC曲线分析显AUC为0.916,95%CI为0.874~0.957。结论 年龄>75岁、住院时间≥15 d、手术治疗、使用呼吸机辅助通气和留置导尿管是泌尿外科老年住院患者院感发生的危险因素,临床实践中应针对上述因素对高危患者人群进行筛查,并实施有针对性的治疗和干预措施以预防感染发生。同时,采用风险预测模型能够对泌尿外科老年住院患者医院感染风险进行科学评价,能够为临床实践提供参考和指导依据。
Objective To analyze the risk factors of nosocomial infection(NI) in the elderly of urology department,and construct a risk prediction model for efficacy validation.Methods A total of 1 050 elderly visited Department of Urology,the Third People's Hospital of Chengdu from January 2022 to December 2022 were enrolled,they were divided into infection group(n=45) and non infection group(1 005) based on the incidence of NI.The risk factors of NI in elderly inpatients of urology department were screened by univariate and multivariate logistic regression analysis methods for constructing a risk prediction model for NI.The goodness of fit test of the risk prediction model was conducted using Hosmer and Lemeshow,and the receiver operating characteristic(ROC) curve was plotted to evaluate the predictive value of the risk prediction model.Results The risk factors for NI in the elderly of urology department were age > 75 years old,hospitalization time ≥ 15 days,surgical treatment,use of ventilator assisted ventilation,and indwelling catheters.The probability model for predicting NI in the elderly of urology department wereP=1/(1+exp [6.055-0.969X1-2.802X2-1.904X4-1.169X5-2.120X6]).The ROC curve analysis showed that the areas under curve(AUC) was 0.916,with a 95% CI of 0.874-0.957.Conclusion Age over 75 years old,hospital stay ≥15 days,surgical treatment,use of ventilator assisted ventilation,and indwelling catheters are risk factors for NI in the elderly of urology department.Therefore,a screening for high-risk patient populations should be conducted based on these factors in clinical practice,thus implementing targeted treatment and intervention measures to prevent infection.In this article,the risk prediction model constructed can scientifically evaluate the risk of NI in elderly of urology department,and providing reference and guidance for clinical practice.
作者
席翔
马筱
卓晖
熊黎强
袁仁斌
曹敏
XI Xiang;MA Xiao;ZHUO Hui(Department of Urology,the Third People’s Hospital of Chengdu,Sichuan,Chengdu 610031,China)
出处
《河北医药》
CAS
2024年第14期2148-2151,2155,共5页
Hebei Medical Journal
基金
四川省卫生健康委员会科研课题(编号:20PJ212)。
关键词
老年住院患者
院内感染
风险预测模型
效能验证
elderly hospitalized patients
nosocomial infection
risk prediction model
effectiveness verification
