Establishment and validation of a clinical prediction model for pulmonary infection in patients during recovery phase of cerebral hemorrhage
Objective To investigate the primary risk factors of pulmonary infection(PI)in patients during the recovery phase of cerebral hemorrhage and to construct and validate a nomogram predictive model for assessing the risk of PI.Methods The clinical data of 761 patients in the recovery phase of cerebral hemorrhage admitted to Department of Hyperbaric Oxygen Medicine,Hefei Second People's Hospital from September 1,2020 to December 31,2022 were retrospectively collected.Based on their clinical manifestations and chest radiography,the patients were divided into a PI group(257 cases),including 116 females and 141 males who were 60(53,70)years old,and a non-PI group(504 cases),including 204 females and 300 males who were 58.5(51,69)years old.Mann-Whitney U and x2 tests were used.The univariate logistic regression was used to screen the risk factors initially,and the risk factors were optimized by the Least Absolute Shrinkage and Selection Operator(LASSO)regression.The model's discriminative ability,calibration,and clinical utility were evaluated by the area(AUC)under the receiver operating characteristic curve(ROC),calibration curve,and decision curve analysis(DCA).Results Age,use of antimicrobial drugs,consciousness disorder,tracheotomy,dysphagia,bedridden duration,and nasogastric feeding were independent risk factors for pulmonary infection in the patients during the recovery phase of cerebral hemorrhage(OR=2.406,5.507,8.878,8.931,2.709,3.402,and 2.528;all P＜0.05),and hyperbaric oxygenation was the protective factor(OR=0.202;P＜0.05).The AUC of the ROC of the predictive model was 0.901(95％CI 0.878-0.924).The bootstrap resampling(1 000 times)yielded an AUC of 0.900(95％CI 0.877-0.923).The Hosmer-Lemeshow test showed a good fit(x2=4.28,P=0.982).Conclusion The nomogram predictive model developed in this study is highly accurate and facilitates the early identification and risk prediction of pulmonary infection in patients during the recovery phase of cerebral hemorrhage.
万方数据
维普
