Risk factors for nosocomial infection in critical patients of emergency department and establishment of prediction model
OBJECTIVE To explore the risk factors for nosocomial infection in the critical patients of emergency de-partment and establish the prediction model.METHODS The clinical data were collected from 343 critical patients who were treated in emergency department of the Affiliated Hospital of Nantong University from Feb 2020 to Feb 2023 and were statistically analyzed.The enrolled patients were divided into the infection group with 51 cases and the non-infection group with 292 cases according to the status of nosocomial infection.The infection sites and pathogens were statistically analyzed,logistic regression analysis was performed for the risk factors for the noso-comial infection in the critical patients,and the prediction model was established.RESULTS The incidence of noso-comial infection was 14.87％(51/343)among the 343 critical patients of emergency department.Among the pa-tients with nosocomial infection,the patients with lower respiratory tract infection accounted for 33.33％,the pa-tients with surgical incision infection 15.69％,the patients with gastrointestinal tract infection 15.69％.Totally 59 strains of pathogens were isolated from the 51 critical patients of emergency department,33(55.93％)of which were gram-negative bacteria,19(32.20％)were gram-positive bacteria,and 7(11.86％)were fungi.The result of logistic analysis showed that excessive use of antibiotics or hormones,multiple sites of lesions,invasive operation,endotracheal intonation or tracheotomy and urinary catheter indwelling were the risk factors for the nosocomial infection in the critical patients of emergency department(OR=2.549,3.274,2.050,2.802,2.230,P＜0.05).ROC curves were drawn for the patients with nosocomial infection based on the diagnostic probability Logit(P),when Logit(P)was more than 0.09,AUC was 0.705,95％CI was 0.632-0.777;the sensitivity of the model was 88.26％in diagnosis,with the specificity 70.51％.CONCLUSION The patients with lower respiratory tract infection are dominant among the critical patients with nosocomial infection in the emergency department.The gram-negative bacteria are the predominant pathogens.The incidence of the nosocomial infection is closely as-sociated with the excessive use of antibiotics or hormones,multiple sites of lesions,invasive operation,endotra-cheal intubation or tracheotomy and urinary catheter indwelling.The prediction model has high value in prediction of nosocomial infection in the critical patients of emergency department.
Nosocomial infectionEmergencyCritical patientPathogenRisk factorPrediction model
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