多发性骨髓瘤患者首次住院院内感染的风险评估  

Risk assessment of nosocomial infection in patients with multiple myeloma in the first hospitalization

作　　者：饶琦 罗婷 王丹丹 RAO Qi;LUO Ting;WANG Dandan(Department of Hematology,West China Hospital,Sichuan University/West China School of Nursing,Sichuan University,Chengdu 610041,Sichuan,China)

机构地区：[1]四川大学华西医院血液科/四川大学华西护理学院,四川成都610041

出　　处：《公共卫生与预防医学》2024年第1期113-115,共3页Journal of Public Health and Preventive Medicine

基　　金：四川省科学技术厅计划项目(23ZDYF1343)。

摘　　要：目的评估多发性骨髓瘤患者首次住院院内感染的风险。方法纳入2021年8月至2022年8月期间四川大学华西医院血液科480例首次住院的多发性骨髓瘤患者,统计治疗期间院内感染情况,分为感染组、未感染组,分析院内感染的独立影响因素,建立预测模型,分析预测模型的可靠性。结果480例首次住院患者中,院内感染发生率为31.25%。感染组与未感染组年龄、ISS分期、控制性营养状况(controlled nutritional status,CONUT)评分、粒细胞缺乏情况、血红蛋白、白蛋白差异均有统计学意义(P<0.05)。Logistic多因素回归分析显示,年龄、ISS分期、CONUT评分、粒细胞缺乏、血红蛋白水平、白蛋白水平均为多发性骨髓瘤患者首次住院院内感染的独立相关因素(P<0.05)。多因素logistic回归预测模型ROC曲线下面积(area under the curve,AUC)为0.88(95%CI:0.840~0.920),敏感度和特异度分别为85.00%、76.36%。结论多发性骨髓瘤患者首次住院院内感染发生率较高。院内感染独立相关因素建立的预测模型对于院内感染发生具有较高的预测价值。Objective To assess the risk of nosocomial infection in patients with multiple myeloma during their first hospitalization.Methods Totally 480 patients with multiple myeloma who were hospitalized for the first time in department of hematology of West China Hospital,Sichuan University from August 2021 to August 2022 were included,and the nosocomial infection during treatment was statistically analyzed.The patients were divided into infected group and uninfected group.The independent influencing factors of nosocomial infection were analyzed and a prediction model was established.The reliability of the prediction model was analyzed by receiver operating characteristic curve(ROC).Results The incidence rate of nosocomial infection was 31.2%among 480 patients hospitalized for the first time.There were statistically significant differences in age,ISS staging,controlling nutritional status(CONUT)score,agranulocytosis,hemoglobin,and albumin between the infected group and the uninfected group(P<0.05).Logistic multivariate regression analysis showed that age,ISS staging,CONUT score,agranulocytosis,hemoglobin level,and albumin level were all independent correlated factors of nosocomial infection in patients with multiple myeloma hospitalized for the first time(P<0.05).The area under the ROC curve(AUC),sensitivity and specificity of multivariate logistic regression prediction model were 0.88(95%CI:0.840-0.920),85.00%and 76.36%,respectively.Conclusion The incidence rate of nosocomial infection is high among patients with multiple myeloma in the first hospitalization.The prediction model established according to independent correlated factors of nosocomial infection has high predictive value on the occurrence of nosocomial infection.

关 键 词：多发性骨髓瘤 首次住院 院内感染 LOGISTIC回归分析 预测模型 

分 类 号：R181[医药卫生—流行病学]