肺癌患者术后发生医院感染预测模型的构建
Establishment of prediction model for postoperative nosocomial infection in lung cancer patients
王苗苗 1兰迪翔 1潘桂芳 1王剑1
作者信息
- 1. 浙江大学医学院附属第二医院临平院区康复科,浙江杭州 311100
- 折叠
摘要
目的 分析肺癌患者行电视辅助胸腔镜根治术(VATS)术后发生医院感染的危险因素,并构建风险预测模型.方法 选取2021年6月-2022年12月浙江大学医学院附属第二医院临平院区收治的150例肺癌患者为研究对象,依据VATS术后感染发生情况分为感染组和未感染组,采用Logistic回归分析医院感染危险因素并构建预测模型,绘制受试者工作特征(ROC)曲线分析模型的预测效能.结果 150例肺癌患者术后共有34例发生感染,术后感染发生率为22.67％;多因素Logistic回归分析结果显示,TNM分期为Ⅲ～Ⅳ期、慢性阻塞性肺疾病、手术时间≥3 h是肺癌患者术后发生医院感染的危险因素(P＜0.05);基于上述危险因素构建的Logistic预测模型:Logistic(P)=-6.797+0.778×TNM分期+0.873×慢性堵塞性肺疾病+1.324×手术时间,该模型预测肺癌患者术后医院感染的敏感度、准确度、阳性预测值、曲线下面积(AUC)分别为81.62％、78.56％、83.42％、0.743.结论 TNM分期、手术时间、合并慢性阻塞性肺疾病是肺癌患者术后医院感染的危险因素,基于上述危险因素构建的模型具有较好的预测价值.
Abstract
OBJECTIVE To analyze the risk factors for the postoperative nosocomial infection in the lung cancer pa-tients undergoing video-assisted thoracic surgery(VATS)and establish the risk prediction model.METHODS To-tally 150 lung cancer patients who were treated in Linping Campus of the Second Affiliated Hospital of Zhejiang University School of Medicine from Jun 2021 to Dec 2022 were recruited as the research subjects and were divided into the infection group and the no infection group according to the status of infection after VATS.Logistic re-gression analysis was performed for the risk factors for the nosocomial infection,the prediction model was estab-lished,and receiver operating characteristic(ROC)curves were drawn to analyze the predictive efficiency of the model.RESULTS Totally 34 of 150 lung cancer patients had the postoperative infection,with the incidence rate 22.67％.The result of multivariate logistic regression analysis showed that Ⅲ-Ⅳ stage of TNM,chronic obstruc-tive pulmonary disease(COPD)and operation duration no less than 3 hours were the risk factors for the postoper-ative nosocomial infection in the lung cancer patients.The logistic prediction model was established based on the above risk factors:Logistic(P)=-6.797+0.778 × TNM stage+0.873 × COPD+1.324 × operation duration;the sensitivity of the model was 81.62％in prediction of the postoperative nosocomial infection in the lung cancer patients,with the accuracy 78.56％,the positive predictive value 83.42％,the area under curve(AUC)0.743.CONCLUSION TNM stage,operation duration and complication with COPD are the risk factors for the postoper-ative nosocomial infection in the lung cancer patients.The model that is established based on the above risk factors has high predictive value.
关键词
肺癌/胸腔镜手术/术后感染/预测模型/预测价值Key words
Lung cancer/Thoracoscopic surgery/Postoperative infection/Prediction model/Predictive value引用本文复制引用
基金项目
浙江省自然科学基金资助项目(LGF19H010002)
浙江省医药卫生科技计划项目(2023XY010)
出版年
2024
NETL
NSTL
维普
万方数据