Building a risk model to predict the risk of hospital acquired pneumonia in patients with chronic heart failure
Objective To investigate the incidence of nosocomial pneumonia in patients with chronic heart failure and construct a logistic risk prediction model.Methods The clinical data of 652 patients with chronic heart failure hospitalized in the Department of cardiovascular medicine of the First Affiliated Hospital of Hainan Medical College from January 2018 to March 2022 were analyzed retrospectively.The distribution of pathogens of nosocomial pneumonia in patients with chronic heart failure was analyzed.The risk factors of nosocomial pneumonia in patients with chronic heart failure were investigated by univariate and multivariate logistic regression analysis.Logistic regression analysis was used to establish a prediction model for investigating the risk of nosocomial pneumonia in patients with chronic heart failure.The receiver operating characteristic(ROC)curve was used to evaluate the prediction effect of the model with the area under the curve(AUC).Results A total of 123 out of the 652 cases developed nosocomial pneumonia,and the main pathogens were gram-negative bacteria(68.10％).Univariate and multivariate logistic regression analysis showed that age ≥7 5 years old(OR=1.586,95％CI:1.011-2.488),heart failure control for more than 3 days(OR=1.718,95％CI:1.042-2.834),use of noninvasive ventilator for more than 3 days(OR=1.613,95％CI:1.014-2.565),combined with moderate or more pleural effusion(OR=1.634,95％CI:1.057-2.525),combined with swallowing dysfunction(OR=4.580,95％CI:2.467-8.499)and hospital stay for more than 7 days(OR=1.853,95％CI:1.126-3.051)were independent risk factors for nosocomial pneumonia in patients with chronic heart failure.The regression model fit well(Hosmer-Leme-show test,x2=9.755,P=0.203)and predicted hospital acquired pneumonia(AUC=0.735,95％CI:0.687-0.782).Conclusions Age,heart failure control,non-invasive ventilation,pleural effusion,swallowing dysfunction,and hospital stay were all influencing factors for the occurrence of hospital acquired pneumonia in patients with chronic heart failure.By establishing a multifactorial logistic risk prediction model,the occurrence of hospital acquired pneumonia in patients with chronic heart failure could be accurately predicted,which could guide clinical intervention work.
Chronic heart failureHospital acquired pneumoniaRisk prediction model
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