Risk factors and nomogram model construction of multi-drug resistance organism(MDRO)infection in ICU patients
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NSTL
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目的 分析ICU患者感染多重耐药菌(Multi-drug resistance organism,MDRO)的危险因素,并构建列线图模型.方法 回顾性分析新疆医科大学第一附属医院2020年1月-2023年12月入住ICU的383例MDRO感染患者临床资料,按照1∶1比例随机选取本院同时期入住ICU的非MDRO感染患者383例的临床资料作对照.通过Logistic回归分析确立独立危险因素,建立模型方程,使用R软件绘制列线图模型.结果 单因素分析结果显示,MDRO感染患者与非MDRO感染患者入院类型、手术、简化急性生理学评分Ⅱ(SAPS Ⅱ)评分、急性生理与慢性健康评分Ⅱ(APACHEⅡ)评分、骨科疾病、使用激素类药物、气管切开、机械通气、中心静脉置管、抗生素联用、抗生素使用时间、白介素-6水平比较,差异均有统计学意义(P＜0.05).多因素分析结果显示,抗生素使用时间、使用激素类药物、入院类型、手术、SAPSⅡ评分、气管切开是ICU患者MDRO感染的独立危险因素(P＜0.05).基于以上6种因素构建列线图模型,经Hosmer-Lemeshow检验,x2=4.857,P=0.773;模型校准曲线与理想曲线吻合良好;受试者工作特征(ROC)曲线显示6种因素联合预测ICU患者MDRO感染的曲线下面积(Area under curve,AUC)为0.829[95％CI:(0.800～0.858)],最佳截断值为0.548,灵敏度为0.708,特异度为0.841.结论 本研究构建的列线图模型拥有良好的临床实用价值,可为临床医务人员早期识别ICU患者MDRO感染风险及制定相应的防控措施提供参考.
Objective The risk factors of multi-drug resistance organism(MDRO)infection in ICU patients were analyzed,and a nomogram model was constructed.Methods The clinical data of 383 MDRO infected patients admitted to ICU in the hospital from January 2020 to December 2023 were retrospectively ana-lyzed,and the clinical data of 383 non-MDRO infected patients admitted to ICU in the same period were randomly selected as controls according to a ratio of 1∶1.The model equation was constructed by Logistic regression analysis,and the nomogram model was drawn by R software.Results Single factor analysis showed that admission type,surgery,simplified acute physiology score Ⅱ(SAPS Ⅱ),acute physiology and chronic health score Ⅱ(APACHE Ⅱ),orthopedic disease,hormone drug use,tracheotomy,mechani-cal ventilation,central venous catheterization,antibiotic combination,the time of antibiotic use and inter-leukin-6,the differences were statistically significant(P＜0.05).The results of multivariate analysis showed that the time of antibiotic use,hormone drug use,damission type,operation,SAPS Ⅱ score and tracheotomy were independent risk factors for MDRO infection in ICU patients(P＜0.05).A nomogram model was constructed based on the above 6 factors,and tested by Hosmer-Lemeshow,x2=4.857,P=0.773;The model calibration curve was in good agreement with the ideal curve.The receiver operating character-istic(ROC)curve showed that the area under curve(AUC)of 6 factors combined to predict MDRO infection in ICU patients was 0.829[95％CI:(0.800～0.858)],the optimal cut-off value was 0.548,the sensitivity was 0.708,and the specificity was 0.841.Conclusion The nomogram model constructed in this study has good clini-cal practical value,which can provide reference for clinical medical personnel to identify the risk of MDRO infection in ICU patients and formulate corresponding prevention and control measures.
ICUmulti-drug resistance organismrisk factornomogram model
NETL
NSTL
万方数据
