Influencing factors and prediction model construction of incontinence-associated dermatitis in ICU patients with fecal incontinence
Objective To analyze the influencing factors of incontinence-associated dermatitis(IAD)in intensive care unit(ICU)patients with fecal incontinence,and thereby construct a nomogram risk prediction model for IAD patients in ICU.Methods A total of 159 patients with fecal incontinence admitted to the comprehensive ICU of a tertiary Grade A hospital in Nanjing from August 2021 to August 2022 were included in this study.Among them,71 cases with IAD were selected as the case group,while 88 cases without IAD selected as the control group.Univariate and binary Logistic regression analyses were conducted to screen factors influencing the occurrence of IAD in patients with fecal incontinence.Based on these findings,a nomogram model was constructed to predict the occurrence of IAD in patients with fecal incontinence.The accuracy and discrimination of the prediction model were evaluated using calibration curves,the Hosmer-Lemeshow(H-L)goodness-of-fit test,and receiver operating characteristic(ROC)curves.Results The incidence of IAD among ICU patients with fecal incontinence was 44.65%in this study.Univariate analysis showed that the PAT scores,frequency of fecal incontinence,watery stools,use of anti-diarrheal medications,and restraint were factors influencing the occurrence of IAD in ICU patients with fecal incontinence(P<0.05).Binary Logistic regression analysis showed that PAT scores,whether the stool were watery and whether antidiarrheal medications were used were factors influencing the occurrence of IAD in ICU patients with fecal incontinence(P<0.05).Specifically,ICU patients with fecal incontinence who had high PAT scores,watery stool,and did not use antidiarrheal medications were at higher risk of developing IAD.Given statistical and clinical significance,a nomogram model was constructed based on PAT score,the fecal incontinence frequency,watery stools,and use of anti-diarrheal medications.The validation results of the nomogram model showed a calibration curve that was a straight line with a slope close to 1,a H-L deviation test(χ2=1.826,P=0.986),and AUC=0.993,demonstrating excellent accuracy and discrimination of the model.Conclusion The incidence of IAD is high among ICU patients with fecal incontinence.The risk prediction model of IAD in ICU patients with fecal incontinence constructed in this study based on 4 influencing factors has good accuracy and discrimination,which is beneficial for medical staffto screen high-risk patients as early as possible and implement personalized intervention strategies,thereby reducing the incidence of fecal incontinence-associated dermatitis.
Intensive care unitFecal incontinenceIncontinence-associated dermatitisInfluencing factorsPrediction model
NETL
NSTL
万方数据
