老年患者腹部外科手术切口感染的风险列线图模型构建  

Nomogram model for prediction of postoperative surgical wound infection in elderly patients with abdominal surgery

作　　者：屈丹[1] 陈燕乔 李鹏[2] QU Dan;CHEN Yan-qiao;LI Peng(Department of Nosocomial Infection Management,the Second Affiliated Hospital of Zhengzhou University,Zhengzhou 450014,China;Department of Infection Control,Henan Provincial People’s Hospital,People’s Hospital of Zhengzhou University,Zhengzhou 450003,China)

机构地区：[1]郑州大学第二附属医院感控管理科,郑州450014 [2]河南省人民医院感染管理科,郑州450003

出　　处：《医药论坛杂志》2024年第4期348-353,共6页Journal of Medical Forum

基　　金：河南省医学科技攻关计划省部共建项目(SBGJ202103021)。

摘　　要：目的通过对老年患者腹部外科手术切口感染危险因素进行分析,预测发生腹部外科手术切口感染的概率。方法回顾性收集2016年至2020年在某三甲医院老年患者进行腹部外科手术的相关资料。采用χ^(2)检验进行组间差异分析,将有统计学意义的变量纳入多因素logistic回归模型;应用R软件建立相应的列线图模型,并对该模型的预测性进行验证。结果研究中共收集2164例老年患者腹部外科手术,经筛选后纳入435例患者,63例出现手术切口感染,感染率为2.91%;在检出的病原体中,革兰阴性杆菌占比75.28%;对比不同组别下患者手术切口感染百分比发现,剖腹术感染率最高;多因素回归显示,慢性肺部疾病(OR=5.159)、糖尿病(OR=1.027)、手术方式(OR=0.021)及住院天数(OR=1.182)是老年患者腹部外科手术切口感染的独立危险因素。列线图模型预测腹部手术切口感染风险的一致性指数为0.881;ROC曲线显示列线图模型预测腹部手术切口感染的曲线下面积为0.880(95%CI:0.831~0.931)。结论本文预测模型有良好的老年患者腹部外科手术切口感染预测能力,通过监测感染风险因子,可预警手术部位切口感染的发生,具有较好的临床实用价值。Objective The risk factors of abdominal surgical wound infection in elderly patients were analyzed to predict the probability of abdominal surgical wound infection.Methods A retrospective study of relevant statistical data from elderly patients with abdominal surgery was conducted at a tertiary teaching hospital from 2016 to 2020.Analysis of differences between groups by chi-square test.The factors which had a statistical significance were screened out by lo-gistic multivariate regression analysis.R software was used to establish the corresponding prediction model of surgical wound infection,and the prediction of the model were verified.Results A total of 2164 elderly patients with abdominal surgery were collected,and 435 patients were enrolled in the study,64 of them had surgical wound infection and the in-fection rate was2.91%;The commonly implicated pathogens were gram-negative bacteria,accounting for 75.28%.Comparison of different types of abdominal surgery wound infection percentage,the highest SSI rate was detected in lapa-rotomy wounds.Multivariate analysis showed that chronic lung diseases(OR=5.159),diabetes(OR=1.027),ap-proach(OR=0.021)and hospital stay(OR=1.182)were independent risk factors for postoperative surgical wound in-fection.The verification results of the nomogram model showed that the consistency index of the model was 0.881.The ROC curve showed that the area under the curve(AUC)for the nomogram model was 0.880(95%CI:0.831-0.931).Conclusion The established nomogram model has high predictive ability for postoperative surgical wound infection in elderly patients with abdominal surgery.Monitoring infection risk factors could forewarning the occurrence of postoperative surgical wound infection,which had practical clinical value.

关 键 词：老年患者 腹部外科手术 手术切口感染 列线图模型 

分 类 号：R619[医药卫生—外科学]