临床误诊误治2024，Vol.37Issue(2) ：44-50.DOI:10.3969/j.issn.1002-3429.2024.02.009

皮肤科住院患者多重耐药菌感染风险诺莫图预测模型的建立与验证

Establishment and Validation of Nomogram Prediction Model for Risk of Multidrug-resistant Organism Infection in Inpatients in Department of Der-matology

朱娜 朱东林 邢雷 隋磊
临床误诊误治2024，Vol.37Issue(2) ：44-50.DOI:10.3969/j.issn.1002-3429.2024.02.009
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  • 维普
  • 万方数据

皮肤科住院患者多重耐药菌感染风险诺莫图预测模型的建立与验证

Establishment and Validation of Nomogram Prediction Model for Risk of Multidrug-resistant Organism Infection in Inpatients in Department of Der-matology

朱娜 1朱东林 1邢雷 1隋磊2
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作者信息

  • 1. 066000 河北 秦皇岛,秦皇岛市第一医院感染管理处
  • 2. 067000 河北 承德,承德医学院附属医院皮肤科
  • 折叠

摘要

目的 通过分析皮肤科住院患者多重耐药菌(MDRO)感染风险的影响因素建立诺莫图预测模型,并进行验证.方法 选取2018 年1 月—2022 年6 月皮肤科住院患者 8 950 例作为研究对象,统计其MDRO感染发生情况,采用Lasso-Logistic回归分析法筛选MDRO感染影响因素,构建诺莫图预测模型,并验证预测模型预测MDRO感染的价值.结果 8 950 例皮肤科住院患者发生MDRO感染782 例,发生率为8.74%.多因素Logistic回归分析显示年龄、免疫性皮肤疾病、侵入性操作、糖尿病、住院天数、长期应用糖皮质激素/免疫抑制剂、抗生素联用、C反应蛋白(CRP)为皮肤科住院患者MDRO感染的独立危险因素(P＜0.01);采用R软件rms程序建立皮肤科住院患者MDRO感染的诺莫图预测模型,该模型预测风险能力指数为0.920,校准度为0.885;受试者工作特征曲线分析显示,该模型预测MDRO感染的曲线下面积为0.945(95%CI:0.903,0.991),敏感度为0.905,特异度为0.918.结论 皮肤科住院患者MDRO感染风险较高,影响因素包括年龄、免疫性皮肤疾病、侵入性操作、糖尿病、住院天数、长期应用糖皮质激素/免疫抑制剂、抗生素联用、CRP,根据上述因素构建的诺莫图预测模型具有较高的预测效能.

Abstract

Objective To establish and verify the nomogram prediction model by analyzing the factors influencing the risk of multi-drug resistant organism(MDRO)infection in inpatients in Department of Dermatology.Methods A total of 8 950 inpatients in Department of Dermatology of our hospital from January 2018 to June 2022 were selected as the research subjects.The incidence of MDRO infection was statistically analyzed,and the influencing factors of MDRO infection were screened by Lasso-Logistic regression analysis.The nomogram prediction model was constructed and the predictive value of the prediction model for MDRO was verified.Results In all,782 cases of MDRO infection occurred in 8 950 inpatients(8.74%).Multivariate Logistic regression analysis showed that age,immune skin disease,invasive procedures,diabetes,length of hospital stay,long-term use of glucocorticoids/immunosuppressants,antibiotic combination,C reactive protein(CRP)were independent risk factors for MDRO infection in dermatological inpatients(P＜0.01).According to this equa-tion,the nomogram prediction model of MDRO infection in inpatients in department of dermatology was established by R soft-ware rms program.The predictive risk index of the model was 0.920,and the calibration degree was 0.885.By receiver oper-ating characteristic(ROC)curve analysis,an area under the curve(AUC)of the model in prediction of MDRO was0.945(95%CI:0.903,0.991),with a sensitivity of 0.905,and a specificity of 0.918.Conclusion The risk of MDRO infection in inpatients in department of dermatology is higher,and the influencing factors include age,immune skin disease,invasive procedures,diabetes,length of hospital stay,long-term use of glucocorticoids/immunosuppressants,antibiotic combination,and CRP.The nomogram prediction model based on the above factors has high predictive performance.

关键词

医院感染/多重耐药菌/皮肤科/住院/影响因素分析/诺莫图预测模型/年龄/住院天数

Key words

Hospital infection/Multi-drug resistant organism/Department of dermatology/Hospitalization/Influen-cing factor analysis/Nomogram prediction model/Age/Length of hospital stay

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基金项目

河北省医学科学研究课题(2024)(20241445)

秦皇岛市重点研发科技支撑计划(202101A157)

出版年

2024
临床误诊误治
解放军白求恩国际和平医院

临床误诊误治

CSTPCD
影响因子：0.914
ISSN：1002-3429
参考文献量32
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