Build a model for predicting urinary tract infection in elderly patients with acute ischemic stroke-induced hemiplegia
Objective To explore the risk factors for urinary tract infection in elderly patients with hemiplegia after acute ischemic stroke,and to construct a nomogram prediction model,so as to provide a basis for clinical treatment of urinary tract infection in elderly patients with acute ischemic stroke.Methods The medical records of 139 elder-ly patients with hemiplegia after acute ischemic stroke who were hospitalized in the Affiliated Hospital of Southwest Medical University and Hejiang County People's Hospital from January 2020 to January 2023 were collected and ret-rospectively analyzed.According to the possible factors of urinary tract infection in patients with cerebral infarction in the previous literature,the influencing factors of urinary tract infection in elderly patients with hemiplegia after a-cute ischemic stroke were screened,the selected statistically significant variables were analyzed by using the logistic regression model,and the obtained risk factors were substituted into the R software,each influencing factor was as-signed according to the size of the regression coefficient,the nomogram prediction model was constructed,and the ROC curve was drawn to evaluate the prediction efficiency.Results Among the 60 elderly patients with acute is-chemic stroke-induced hemiplegia who developed urinary tract infections,44 cases(73.33％)were infected with Gram-negative bacteria and 16 cases(26.67％)were infected with Gram-positive bacteria.The infection group had a higher proportion of females,diabetes comorbidity,indwelling urinary catheter use,as well as higher levels of serum TLR4,HMGB1,and NF-κB compared to the non-infection group(P＜0.05).Female gender(OR=3.691,95％CI:1.812-7.520),diabetes comorbidity(OR=3.522,95％CI:1.719-7.238),indwelling urinary catheter use(OR=4.023,95％CI:1.910-8.472),TLR4(OR=4.909,95％CI:2.331-10.338),HMGB1(OR=4.175,95％CI:1.982-8.792)and NF-κB(OR=4.509,95％CI:2.141-9.495)evelation were identified as risk factors for urinary tract infections in elderly patients with acute is-chemic stroke-induced hemiplegia(P＜0.05).The Alignment Diagram model predicted a sensitivity of 0.806(95％CI:0.741-0.896),specificity of 0.812(95％CI:0.761-0.975),and an area under the curve of 0.809(95％CI:0.745-0.913)for predicting urinary tract infections in elderly patients with acute ischemic stroke-induced hemiplegia.Conclusion Female gender,comorbidity of diabetes,use of indwelling urinary catheter,as well as elevated levels of serum TLR4,HMGB1,and NF-κB are associated with the occurrence of urinary tract infections in elderly patients with acute is-chemic stroke-induced hemiplegia.Constructing an Alignment Diagram model could predict urinary tract infection.
Acute ischemic strokeHemiplegiaUrinary tract infectionPrediction model
NETL
NSTL
万方数据
