老年急性脑梗死后并发肺炎的危险因素及列线图预测模型构建  

Risk factors for pneumonia in elderly patients with acute cerebral infarction and construction of a nomogram prediction model

作　　者：高琴 梁猛军[1] 赵平 袁丽俐 朱才丰[1] Gao Qin;Liang Mengjun;Zhao Ping;Yuan Lili;Zhu Caifeng(Department of Emergency,Second Affiliated Hospital of Anhui University of Traditional Chinese Medicine,Hefei,Anhui,230061,P.R.China)

机构地区：[1]安徽中医药大学第二附属医院急诊科,安徽合肥230061

出　　处：《老年医学与保健》2025年第1期74-77,87,共5页Geriatrics & Health Care

基　　金：安徽省华佗中医药研究院科技重大专项“揭榜挂帅”项目(BZKZ2402);国家级重点专科项目--老年病优势专科建设。

摘　　要：目的探讨老年急性脑梗死(ACI)患者并发肺炎的影响因素,并建立列线图预测模型。方法选取2022年1月—2024年11月安徽中医药大学第二附属医院收治的200例老年ACI患者作为研究对象,根据是否发生肺炎,将其分为发生组(n=50例)和未发生组(n=150例),采用多因素Logistic回归筛选其并发肺炎的危险因素,采用R(4.2.3)构建其列线图模型,并对其进行验证。结果多因素Logistic回归分析显示,年龄、吸烟、糖尿病、吞咽障碍、营养不良、住院时间、CRP是老年ACI患者并发肺炎的危险因素(P<0.05);构建列线图风险预测模型,其校正曲线的实际值与预测值一致性较好,H-L拟合优度检验结果显示,χ2=4.051,P=0.853;1周、2周及3周并发肺炎的ROC曲线下面积(AUC)分别为0.709(95%CI:0.650~0.767)、0.696(95%CI:0.634~0.757)及0.642(95%CI:0.578~0.706)。结论年龄、吸烟、糖尿病、吞咽障碍、营养不良、住院时间、CRP可能是老年ACI患者并发肺炎的危险因素;根据危险因素构建的列线图模型可能具有较高的预测准确性。Objective To investigate the risk factors for pneumonia in elderly patients with acute cerebral infarction(ACI)and construct a nomogram prediction model.Methods 200 elderly ACI patients admitted to Second Affiliated Hospital of Anhui University of Traditional Chinese Medicine from January 2022 to November 2024 were selected as the study subjects.According to whether pneumonia occurred,they were divided into occurrence group(n=50 cases)and non-occurrence group(n=150 cases).Multivariate Logistic regression analysis was used to identify risk factors,and a nomogram prediction model was developed by R software(version 4.2.3)and validated.Results The results of multifactorial Logistic regression analysis showed that age,smoking,diabetes mellitus,dysphagia,malnutrition,length of hospitalization and CRP were the risk factors for pneumonia in elderly ACI patients(P<0.05).The nomogram model demonstrated good predictive accuracy.The calibration curve showed good agreement between predicted and actual values.Hosmer-Leme show goodness-of-fit test indicated satisfactory model fit(0x0E䥺SymbolcA@0x0F 2=4.051,P=0.853).The area under the ROC curve(AUC)for pneumonia prediction at 1 week,2 weeks,and 3 weeks was 0.709(95%CI:0.650--0.767),0.696(95%CI:0.634--0.757),and 0.642(95%CI:0.578--0.706),respectively.Conclusion Age,smoking,diabetes,dysphagia,malnutrition,length of hospitalization and CRP are significant risk factors for pneumonia in elderly ACI patients.The nomogram model constructed based on these risk factors may have high predictive accuracy.

关 键 词：老年 急性脑梗死 肺炎 危险因素 列线图 预测模型 

分 类 号：R563.1[医药卫生—呼吸系统] R743.3[医药卫生—内科学]