首页|经口气管插管患者口腔黏膜压力性损伤风险预测模型的构建与验证

经口气管插管患者口腔黏膜压力性损伤风险预测模型的构建与验证

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目的 构建经口气管插管患者口腔黏膜压力性损伤(Oral Mucosal Pressure Injury,OMPI)的风险预测模型,并验证该模型的预测效果.方法 便利选取2023年1-9月在ICU住院的335例经口气管插管患者作为建模集,根据是否发生OMPI,将其分为OMPI组(47例)和非OMPI组(288例).采用单因素分析和多因素logistic回归分析确定OMPI发生的独立危险因素,并基于独立危险因素构建风险预测模型,绘制列线图.选取2023年10-12月同一所医院同一 ICU的143例经口气管插管患者作为验证组,并采用ROC曲线和DCA进行模型验证.结果 经口气管插管患者OMPI发生率为14.03％.每日口腔护理次数、气管插管时间、气管导管材质、是否使用牙垫、每日口腔吸引次数、RASS评分及糖尿病病史是其危险因素(均P＜0.05).该模型在验证集中的ROC曲线下面积为0.908[95％CI(0.856,0.960)],灵敏度为84.0％,特异度为87.5％,模型总正确率为87.41％.结论 该风险预测模型的预测效果良好,可为医务人员评估经口气管插管患者OMPI发生风险提供参考.
Construction and validation of a predictive model for oral mucosal pressure injury in patients with oral endotracheal intubation
Objective To construct a risk prediction model for Oral Mucosal Pressure Injury(OMPI)in patients with oral endotra-cheal intubation,and to verify the predictive effect of the model.Methods A sample of 335 patients with oral endotracheal intuba-tion who were hospitalized in ICU from January to September 2023,were included into the modeling dataset,and divided into the OMPI group(47 cases)and the non-OMPI group(288 cases)according to whether or not they developed OMPI.Risk factors for the occurrence of OMPI were determined using univariate analysis and multifactorial logistic regression analysis.Then a risk pre-diction model was constructed based on the risk factors and a nomogram was plotted.Another sample of 143 patients with oral en-dotracheal intubation in the same ICU from October to December 2023 were selected as the validation dataset,and the receiver operator characteristic(ROC)curve and decision curve analysis(DCA)were used for validation of the prediction model.Results The incidence rate of OMPI in patients with oral endotracheal intubation was 14.03％.The number of daily oral care,duration of endotracheal intubation,tracheal tube material,the use of dental pads or not,the number of daily oral suctioning,the RASS score and history of diabetes mellitus were the risk factors(all P＜0.05).In the validation dataset,the area under the ROC curve was 0.908[95％CI(0.856-0.960)];the the model had a sensitivity of 84.0％,a specificity of 87.5％and an overall prediction cor-rectness of 87.41％.Conclusion The risk prediction model has good predictive effect and can provide a reference for medical staff to assess the risk of OMPI occurrence in patients.

critical patientsendotracheal intubationoral mucosal pressure injuriesdevice-associated pressure injuriesoral caredental padsoral suctionprediction models

辜甜田、黄光梅、张培、雷兰琼、梁永君、陈俊希

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遵义医科大学附属医院护理部(贵州 遵义,563000)

遵义医科大学附属医院重症医学科(贵州 遵义,563000)

遵义医科大学护理学院

危重患者 气管插管 口腔黏膜压力性损伤 器械相关性压力损伤 口腔护理 牙垫 口腔吸引 预测模型

贵州省科技计划项目遵义市科技计划项目

黔科合成果-LC[2024]043遵市科合字2023441号

2024

10.3870/j.issn.1001-4152.2024.20.064

护理学杂志
华中科技大学同济医学院

护理学杂志

CSTPCD北大核心
影响因子：2.062
ISSN：1001-4152
年,卷(期)：2024.39(20)