Establishment of a nursing warning model for disease change in patients with upper gastrointestinal bleeding based on case studies
Objective:To identify the risk factors for disease change in patients with upper gastrointestinal bleeding,and to establish and validate a nursing warning model for disease change in patients in the early stage after admission.Methods:A total of 400 patients with upper gastrointestinal bleeding who were admitted to a grade A tertiary hospital in Chongqing,China were enrolled as subjects,and a retrospective study was conducted with rebleeding,transfer to the ICU,and death as the composite indicators of disease change.According to the presence or absence of the above changes,the patients were divided into disease change group with 176 patients and non-disease change group with 224 patients.The chi-square test,t-test,and logistic regression analysis were used to investigate the risk factors for disease change and establish a nursing warning model for disease change in patients with upper gastrointestinal bleed-ing,and the receiver operating characteristic(ROC)curve was used to assess the predictive efficacy of the model.Results:The univari-ate analysis showed that there were significant differences between the disease change group and the non-disease change group in age,body temperature on admission,pulse on admission,respiration on admission,sex,use of nonsteroidal anti-inflammatory drugs,chief complaint(tarry stool and hematemesis),and hemoglobin(P＜0.05).The binary logistic regression analysis showed that age(odds ratio[OR]=1.02,95％CI=1.00-1.03),sex(OR=2.27,95％CI=1.36-3.77),use of nonsteroidal anti-inflammatory drugs(OR=2.32,95％CI=1.32-4.09),body temperature on admission(OR=7.36,95％CI=3.17-17.08),chief complaint of tarry stool(OR=2.09,95％CI=1.04-4.22),chief complaint of hematemesis(OR=4.42,95％CI=2.13-9.19),respiration on admission(OR=0.78,95％CI=0.67-0.91),and hemoglobin(OR=0.98,95％CI=0.98-0.99)were independent influencing factors for disease change in patients with upper gastrointestinal bleeding.The nursing warning model for disease change established had an area under the ROC curve of 0.790,and the Hosmer-Lemeshow test of model calibration showed good degree of fitting(x2=3.702,P=0.883).Conclusion:The nursing warning model for disease change established has a reliable predictive value,which pro-vides a reference for the early screening for potential disease changes in patients with upper gastrointestinal bleeding and the perfor-mance of predictive nursing.
patients with upper gastrointestinal hemorrhagedisease changerisk factorswarning model
万方数据
维普
