ICU医院感染风险预测模型构建及评价  

Construction and evaluation of the prediction model for nosocomial infection in ICU

作　　者：王莉[1] 梁秀云 张爱英 孙吉花[2] 纪冰[3] 历艳娟 孟亚宁 WANG Li;LIANG Xiu-yun;ZHANG Ai-ying;SUN Ji-hua;JI Bing;LI Yan-juan;MENG Ya-ning(Qilu Hospital of Shandong University Dezhou Hospital,Dezhou,Shandong 254300,China;不详)

机构地区：[1]山东大学齐鲁医院德州医院医院感染管理科,山东德州254300 [2]滨州医学院附属医院医院感染管理办公室,山东滨州256603 [3]滨州医学院附属医院医院检验科,山东滨州256603

出　　处：《中华医院感染学杂志》2024年第19期3012-3016,共5页Chinese Journal of Nosocomiology

基　　金：山东省自然科学基金面上基金资助项目(ZR2020MH309)。

摘　　要：目的分析ICU发生医院感染的危险因素,构建ICU患者医院感染预测模型并评价营养风险筛查工具2002(NRS2002)的预测价值。方法回顾性收集山东大学齐鲁医院德州医院2022年发生医院感染的ICU患者79例作为医院感染组,未发生感染的115例为未感染组,采用多因素Logistic回归模型归纳ICU患者医院感染的危险因素,采用似然比χ^(2)、拟合优度检验评价模型,受试者工作特征(ROC)曲线评价模型对ICU医院感染的预测价值。结果两组患者营养风险筛查工具2002(NRS2002)评分、住院时间、住院费用、抗菌药物费用、ICU住院时间、呼吸机使用时间、中心静脉置管时间、急性生理与慢性健康Ⅱ(APACHEⅡ)评分、出院转归、年龄、糖尿病史、贫血情况、抗菌药物使用情况及级别、白蛋白正常、前白蛋白正常差异有统计学意义(P<0.05);经多因素Logistic回归分析回归方程:Logistic(P)=9.073+1.299×糖尿病史+0.161×ICU住院时间+0.088×中心静脉置管时间+0.77×NRS2002评分+0.112×APACHEⅡ评分;曲线下面积为0.923。结论NRS2002评分、糖尿病病史、ICU住院时间、中心静脉置管时间、APACHEⅡ评分是ICU医院感染的危险因素,据此构建ICU医院感染风险预测模型具有良好的预测价值。OBJECTIVE To analyze the risk factors for the occurrence of nosocomial infection in ICUs,to construct a prediction model for nosocomial infection in ICU patients and evaluate the predictive value of the Nutritional Risk Screening Tool 2002(NRS2002).METHODS A total of 79 ICU patients with nosocomial infection in Dezhou Hospital and Qilu Hospital of Shandong University in 2022 were retrospectively collected and set as the nosocomial infection group,and 115 patients without infection were set as the non-infection group.Multivariate Logistic regression model was used to summarize the risk factors for nosocomial infection in ICU patients.The model was evaluated by likelihood ratio χ^(2) and goodness of fit test,and the receiver operating characteristic(ROC)curve was used to evaluate the predictive value of the model for ICU nosocomial infection.RESULTS There were significant differences in the NRS2o02 score,hospitalization time,hospitalization cost,antibiotic cost,ICU hospitalization time,ventilator use time,central venous catheterization time,acute physiology and chronic health Ⅱ(APACHEⅡ)score,discharge outcome,age,history of diabetes,anemia,antibiotic use level,normal albumin,and nomal pre-albumin between the tow groups(P<0.05);The regression equation of multivariate logistic regression analysis was:Logistic(P)=9.073+1.299 X history of diabetes+0.161×ICU hospitalization time+0.088× central venous catheterization time+0.77× NRS2002 score+0.112× APACHE Ⅱ score,area under the curve of the logistic regression model was 0.923.CONCLUSION The NRS2002 score,history of diabetes,ICU hospitalization time,central venous catheterization time,and APACHE Ⅱ score were the risk factors for ICU nosocomial infection,and the prediction model for ICU nosocomial infection constructed based on these factors had good predictive value.

关 键 词：ICU 营养风险筛查工具2002评分 医院感染 危险因素 预测模型 

分 类 号：R183[医药卫生—流行病学]