不同评分对监护病房发生医院感染的评估价值  

Evaluation value of different scores on hospital infection in intensive care unit

作　　者：李萍 张野 戴桂英 李晓蕾[1] 魏兵[1] 刘文红[1] 王军宇[1] LI Ping;ZHANG Ye;DAI Guiying;LI Xiaolei;WEI Bing;LIU Wenhong;WANG Junyu(Emergency Medicine Clinical Research Center,Beijing Chaoyang Hospital Affiliated to Capital Medical University,Beijing Key Laboratory of Cardiopulmonary Cerebral Resuscitation,Clinical Center for Medicine in Acute Infection,Capital Medical University,Beijing 100046,China)

机构地区：[1]首都医科大学附属北京朝阳医院急诊医学临床研究中心,心肺脑复苏北京市重点实验室,首都医科大学急性感染临床诊疗与研究中心,北京100046

出　　处：《中国现代医生》2023年第30期76-80,共5页China Modern Doctor

摘　　要：目的探讨不同评分系统对三甲医院重症监护病房中危重症患者发生医院感染的评估价值。方法选择2016年6月至2020年6月在首都医科大学附属北京朝阳医院西区急诊监护室住院的184例患者为研究对象。根据住院期间是否发生医院感染,将其分为医院感染(hospital infection,HI)组98例和非医院感染(non-hospital infection,NHI)组86例。比较两组患者入院时的基础情况、Barthel评分、Braden压疮危险评分、格拉斯哥昏迷评分(Glasgow coma score,GCS)、营养风险筛查(nutritional risk screening 2002,NRS2002)评分、急性生理学和慢性健康评估系统Ⅱ(acute physiology and chronic health evaluation scoring systemⅡ,APACHEⅡ)评分及血糖等生化指标。Logistic回归分析患者发生医院感染的独立预测因素。受试者操作特征曲线(receiver operating characteristic curve,ROC曲线)分析不同评分系统对发生医院感染的预测价值。结果与NHI组相比,HI组患者的APACHEⅡ及NRS2002评分均显著增高(P<0.05);GCS、Barthel及Braden评分均显著降低(P<0.05)。Logistic回归分析显示:Braden及NRS2002评分是医院感染发生的独立预测因素。分析显示Braden和NRS2002评分预测患者医院感染发生的ROC曲线下面积(area under the curve,AUC)分别是0.709、0.684(Z=0.588,P=0.556)。结论Braden和NRS2002评分对重症监护室患者发生医院感染有较好的预测价值。Objective To explore the value of different scoring systems in the evaluation of hospital infection in critically ill patients in the intensive care unit of the third-class hospital.Methods A total of 184 patients hospitalized in the western emergency intensive care unit of Beijing Chaoyang Hospital Affiliated to Capital Medical University from June 2016 to June 2020 were selected as the research objects.According to whether hospital infection occurred during hospitalization,they were divided into 98 cases in hospital infection(HI)group and 86 cases in non-hospital infection(NHI)group.The basic situation,Barthel score,Braden score,Glasgow coma score(GCS),nutritional risk screening 2002,NRS2002(NRS 2002),acute physiology and chronic health evaluation scoring systemⅡ(APACHEⅡ),blood glucose and other biochemical indexes of the two groups were compared.Logistic regression analysis was used to analyze the independent predictors of hospital infection.The predictive value of different scoring systems was analyzed by receiver operating characteristic(ROC)curve.Results Compared with the NHI group,the APACHEⅡand NRS2002 in the HI group were significantly higher(P<0.05).The Barthel,Braden and GCS score were significantly reduced(P<0.05).Logistic regression analysis showed that Braden score and NRS 2002 score were independent predictors of hospital infection.Analysis showed that the ROC area under the curve(AUC)predicted by Braden score and NRS 2002 score were 0.709 and 0.684 respectively(Z=0.588,P=0.556).Conclusion Braden score and NRS 2002 score have good predictive value for hospital infection in critically ill patients.

关 键 词：监护病房 医院感染 Barthel评分 APACHEⅡ评分 BRADEN评分 NRS2002评分 GCS评分 

分 类 号：R449[医药卫生—诊断学]