Risk factors and prediction model construction of urinary tract infection in elderly patients with diabetic nephropathy
Objective To analyze the risk factors of urinary tract infection in elderly patients with diabetic nephropathy,and to establish a predictive model.Methods From June 2018 to June 2023,a total of 240 elderly patients with type 2 diabetic ne-phropathy who visited General Hospital of Northern Theater Command of Chinese PLArmy Hospital were research object,of which 168 were included in disease group 1 and 72 were included in disease group 2.Disease group 1 included 52 cases of urinary tract infections(combined group)and 116 cases of non infection(non combined group);The disease group 2 included 26 cases of infection and 46 cases of non infection.Baseline and laboratory data were compared between disease group 1 and disease group 2,and between the com-bined group and non combined group;Multivariate logistic regression was applied to analyze the risk factors of urinary tract infections;The nomogram model was constructed based on the selected risk factors and validated,and consistency was checked by generating cali-bration curves.Results There was no significant difference in the data between disease group 1 and disease group 2(P＞0.05).The gender,course of disease,use of catheter,glycosylated hemoglobin(HbA1c),urinary albumin/creatinine ratio,estimated glomerular filtration rate(eGFR),and cystatin C(Cys-C)of the combined group and the non combined group in disease group 1 were statisti-cally significant(P＜0.05).Multivariate logistic regression analysis showed that female,urinary catheter,HbA1c＞7.5％,high Cys-C and low eGFR were the risk factors of urinary tract infection in elderly patients with diabetes nephropathy(P＜0.05).A nomogram was constructed from the results of multivariate logistic regression analysis.In the ROC curve for validating the nomogram model,the ar-ea under the curve was higher in disease group 1 and disease group 2[0.915(95％CI:0.871～0.959)and 0.926(95％CI:0.865～0.986)](P＜0.05).The fitting test results showed that the application performance of the prediction model was good in the disease 1 group and the disease 2 group,and the difference between the prediction results and the actual results was not significant(P＞0.05).Calibration curve showed that disease group 1 and disease group 2 were almost consistent with the ideal curve in this prediction model.Conclusion Female,urinary catheter,HbA1c＞7.5％,high Cys-C and low eGFR are the risk factors of urinary tract infection in eld-erly patients with diabetic nephropathy.The prediction model has clinical advantages in accuracy and consistency.
万方数据
维普
