基于logistic回归分析重症脑卒中患者术后肺部感染的危险因素  

Risk factors of postoperative pulmonary infection in patients with severe stroke were analyzed based on logistic regression

作　　者：许绯[1] 秦虹霞 陈亮[1] XU Fei;QIN Hong-xia;CHEN Liang(Department of Neurology,Anyang People's Hospital,Anyang,Henan 455000,China)

机构地区：[1]安阳市人民医院神经内科,河南安阳455000

出　　处：《医药论坛杂志》2023年第12期38-42,共5页Journal of Medical Forum

摘　　要：目的探究基于的logistic回归分析重症脑卒中患者术后肺部感染的危险因素及PCT、CRP预测感染的临床价值。方法选择2019年10月—2022年10月期间安阳市人民医院重症脑卒中手术患者320例作为研究对象,按照术后是否肺部感染分为非感染组(n=255)及感染组(n=65),收集全部入选全部病例基线资料、疾病方面因素、手术情况、临床给药情况、侵入性操作等,基于单因素分析结果进行logistic回归分析,剖析重症脑卒中患者术后感染的危险因素,并且提出防治措施。结果基于单因素分析结果进行logistic回归分析,logistic回归分析结果表明,年龄≥75岁、入院时GCS评分≥9分、机械通气、ICU住院时间≥72 h、院外转入、前期使用抗生素、术后3 d PCT≥2.5 ng/L、术后3 d CRP≥15.0 mg/L、静脉全麻是患者术后感染的独立危险因素(P<0.05)。PCT预测术后感染诊断效能灵敏度为99.13%,特异度为100.00%,阳性预测值为100.00%,阴性预测值为83.33%,较CRP诊断效能高(P<0.05)。结论重症脑卒中患者术后感染是由多因素综合作用的影响,因此需要从各方面因素进行防治,术后3d监测血清PCT,有助于对手术部位感染的预测及早期干预。Objective The risk factors of postoperativepulmonary infection infection in patients with severe stroke and the clinical value of PCT and CRP in predicting infection were analyzed based on logistic regression.Methods Totally 320 patients undergoing surgery for severe stroke in our hospital from October 2019 to October 2022 were selected as study subjects.They were divided into infection group(n=65) and non-infection group(n=255) according to postoperative pulmonary infection.Baseline data,disease factors,surgical conditions,clinical administration,invasive procedures,etc.,were collected for logistic regression analysis based on univariate analysis results.Results Logistic regression analysis was carried out based on the results of single factor analysis.The results of logistic regression analysis showed that,Age ≥ 75 years old,GCS score at admission ≥ 9 points,mechanical ventilation,ICU stay ≥ 72 h,out-hospital transfer,early use of antibiotics,PCT ≥ 2.5 ng/L after surgery,CRP ≥ 15.0 mg/L after surgery,intravenous general anesthesia were independent risk factors for postoperative infection(P<0.05).The sensitivity,specificity,positive predictive value and negative predictive value of PCT in predicting postoperative infection were 99.13%,100.00%,100.00% and 83.33%,respectively,which were higher than that of CRPs(P<0.05).Conclusion Postoperative infection in patients with severe stroke is affected by multiple factors,so it is necessary to prevent and cure the infection from various factors.The monitoring of serum PCT on 3d after surgery is helpful for the prediction and early intervention of surgical site infection.

关 键 词：重症脑卒中 术后感染 危险因素 防治措施 合并慢性疾病 手术时间 

分 类 号：R743.3[医药卫生—神经病学与精神病学]