呼吸道急症病人长期住院护理风险预测模型构建  

Construction and analysis of risk prediction model for long-term hospitalization of patients with respiratory tract emergencies

作　　者：厉俊 彭瑶[1] 罗香姣[1] 朱焕 王瑞花 LI Jun;PENG Yao;LUO Xiangjiao;ZHU Huan;WANG Ruihua(Department of Emergency,The Second Affiliated Hospital of Hu'nan University of Traditional Chinese Medicine,Changsha Hu'nan 410000,China)

机构地区：[1]湖南中医药大学第二附属医院急诊科,湖南长沙410000

出　　处：《蚌埠医科大学学报》2025年第2期271-275,共5页Journal of Bengbu Medical University

基　　金：国家自然科学基金资助项目(81503561)。

摘　　要：目的:探讨呼吸道急症病人长期住院护理风险预测模型构建。方法:回顾性选取呼吸道急症病人211例作为研究对象,随机选取70%(148例)病例作为训练集,30%(63例)作为测试集。统计训练集病人住院护理时间,将超过中位住院时间(≥8 d)作为长期住院组46例,其余作为非长期住院组102例,比较2组一般资料、实验室资料,采用多因素logistic风险筛选呼吸道急症长期住院护理风险的相关因素,基于训练集建立列线图预测模型,绘制校正曲线验证预测模型内部效能,并在测试集评估模型外部效能。结果:长期住院组接受机械通气治疗占比高于非长期住院组,共病指数(CCI)、营养风险筛查评分简表(NRS2002)评分、动脉二氧化碳分压(PaCO 2)水平均高于非长期住院组(P<0.01)。多因素logistic分析显示,CCI、机械通气治疗、PaCO 2、NRS2002评分为呼吸道急症病人长期住院风险的独立危险因素(P<0.05~P<0.01),上述因素预测呼吸道急症病人长期住院风险相关因素的一致性指数为0.951(95%CI:0.919~0.982)。测试集中长期住院19例,非长期住院44例,模型外部验证显示敏感性为84.21%,特异性为88.64%,准确率为87.30%。结论:构建了呼吸道急症病人长期住院护理风险预测模型,机械通气治疗、入院时PaCO 2水平、CCI、NRS2002评分为呼吸道急症病人长期住院护理风险危险因素。Objective:To explore the construction of a risk prediction model for long-term hospitalization care of respiratory emergency patients.Methods:A retrospective selection of 211 patients with respiratory emergencies was conducted,with 70%(148 cases)randomly selected as the training set and 30%(63 cases)as the test set.The length of hospitalization and nursing care for patients in the training set was statistically analyzed,including 46 patients in the long-term hospitalization group who exceeded the median length of stay(≥8 days)and 102 patients in the non-long-term hospitalization group.The general data and laboratory data of the two groups in the training set were compared,multivariate logistic risk was used to screen the relevant factors for long-term hospitalization and nursing risk of respiratory emergencies,a nomogram prediction model based on the training set was established,and a correction curve was drawn to verify the internal effectiveness of the prediction model,and the external effectiveness of the model in the test set was evaluated.Results:The proportion of patients receiving mechanical ventilation treatment in the long-term hospitalization group was higher than that in the non-long-term hospitalization group,and the comorbidity index(CCI),NRS 2002 score,and arterial partial pressure of carbon dioxide(PaCO 2)levels were higher than those in the non-long-term hospitalization group(P<0.01).Multivariate logistic analysis showed that CCI,mechanical ventilation treatment,PaCO 2,and NRS2002 scores were independent risk factors for long-term hospitalization risk in patients with respiratory emergencies(P<0.05 to P<0.01).The consistency index of the above factors predicting long-term hospitalization risk in patients with respiratory emergencies was 0.951(95%CI:0.919-0.982).In the test set,there were 19 long-term hospitalization patients and 44 non-long-term hospitalization patients.External validation of the model showed a sensitivity of 84.21%,a specificity of 88.64%,and an accuracy rate of 87.30%.Conclusi

关 键 词：呼吸道疾病 长期住院风险 营养风险筛查评分简表 预测模型 

分 类 号：R562[医药卫生—呼吸系统]