中华现代护理杂志2024,Vol.30Issue(11) :1489-1496.DOI:10.3760/cma.j.cn115682-20230824-00678

老年急性白血病患者化疗期间发生PICC相关血流感染风险预测模型的构建与验证

Construction and validation of a risk prediction model for PICC related bloodstream infections in elderly acute leukemia patients during chemotherapy

郭娟 曹伟杰 张素平 刘娜 丁一虹
中华现代护理杂志2024,Vol.30Issue(11) :1489-1496.DOI:10.3760/cma.j.cn115682-20230824-00678

老年急性白血病患者化疗期间发生PICC相关血流感染风险预测模型的构建与验证

Construction and validation of a risk prediction model for PICC related bloodstream infections in elderly acute leukemia patients during chemotherapy

郭娟 1曹伟杰 1张素平 1刘娜 1丁一虹1
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作者信息

  • 1. 郑州大学第一附属医院血液内科,郑州 450000
  • 折叠

摘要

目的 探讨老年急性白血病患者化疗期间发生经外周静脉置入中心静脉导管(PICC)相关血流感染的危险因素,并构建和验证相关预测模型.方法 收集郑州大学第一附属医院2019年1月-2020年12月的291例患者资料作为建模组,2021年1月-2022年12月的277例患者作为验证组.采用多因素Logistic回归分析确定老年急性白血病患者化疗期间发生PICC相关血流感染的危险因素,根据分析结果构建并验证预测模型.结果 建模组中PICC相关血流感染发生率为8.2%(24/291).多因素Logistic回归分析结果显示,化疗次数、单次置管穿刺次数、导管维护频率是否规范、导管留置时间是老年急性白血病患者化疗期间发生PICC相关血流感染的危险因素.根据此结果构建预测模型,结果显示建模组预测模型的受试者工作特征曲线下面积为0.798(95%置信区间:0.734~0.869),验证组预测模型的受试者工作特征曲线下面积为0.745(95%置信区间:0.712~0.844).建模组与验证组的校正曲线显示该预测模型具有较高的预测效能.结论 本研究根据多因素分析结果构建了老年急性白血病患者化疗期间发生PICC相关血流感染的预测模型,并进一步验证了该预测模型的预测效能.护理人员可根据该预测模型量化患者发生PICC相关血流感染的风险,实施针对性护理措施.

Abstract

Objective To explore the risk factors for peripherally inserted central catheter(PICC)related bloodstream infections in elderly acute leukemia patients during chemotherapy,and construct and validate relevant predictive models.Methods This study selected 291 patients from the First Affiliated Hospital of Zhengzhou University from January 2019 to December 2020 as the modeling group,and 277 patients from January 2021 to December 2022 as the validation group.Multivariate Logistic regression was used to determine the risk factors for PICC related bloodstream infections during chemotherapy in elderly acute leukemia patients,and a prediction model was constructed and validated based on the analysis results.Results The incidence of PICC related bloodstream infections in the modeling group was 8.2%(24/291).Multivariate Logistic regression analysis showed that chemotherapy frequency,single catheterization puncture frequency,whether catheterization maintenance frequency was standardized,and catheterization retention time were risk factors for PICC related bloodstream infections in elderly acute leukemia patients during chemotherapy.Based on this result,a prediction model was constructed,and the area under the receiver operating characteristic curve(AUC)of the modeling group's prediction model was 0.798[95%CI(0.734,0.869)],while the AUC of the validation group's prediction model was 0.745[95%CI(0.712,0.844)].The calibration curves of the modeling and validation groups showed that the prediction model had high predictive performance.Conclusions A prediction model for PICC related bloodstream infections in elderly acute leukemia patients during chemotherapy is constructed based on the results of multiple factor analysis,and the predictive performance of the model is verified.Nursing staff can quantify the risk of PICC related bloodstream infections in patients based on this prediction model and implement targeted nursing measures.

关键词

白血病/急性白血病/老年患者/经外周静脉置入中心静脉导管/血流感染/预测模型

Key words

Leukemia/Acute leukemia/Elderly patients/Peripherally inserted central catheter/Bloodstream infections/Prediction model

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出版年

2024
中华现代护理杂志
中华医学会

中华现代护理杂志

CSTPCD
影响因子:1.14
ISSN:1674-2907
参考文献量20
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