目的 探究重症监护室(intensive care unit,ICU)更年期女性患者入住时间延长的危险因素并构建预测模型.方法 选取 2019 年 6 月至 2022 年 12 月台州市中心医院ICU住院的更年期女性 260 例为研究对象,根据患者ICU住院时间将其分为延长组(≥5d,156 例)和未延长组(<5d,104 例).收集患者的临床资料,采用多因素Logistic回归分析ICU患者住院时间延长的影响因素,构建列线图预测模型,绘制受试者操作特征曲线并计算曲线下面积(area under the curve,AUC).结果 延长组患者的昏迷、进行侵袭操作及使用广谱抗生素的占比均显著高于未延长组(P<0.05);延长组患者的血压异常、肌肉/骨关节疼痛、心率异常、呼吸功能异常及感染发生率均显著高于未延长组患者(P<0.05);多因素Logistic回归分析结果显示,昏迷、侵袭操作、使用广谱抗生素、血压异常、心率异常、呼吸功能异常、感染均是导致更年期女性ICU住院时间延长的危险因素(P<0.05);构建的列线图模型拟合度良好(χ2=5.072,P=0.285);列线图模型预测患者ICU住院时间延长的AUC为 0.857(95%CI:0.778～0.937),敏感度为 78.16%,特异性为 83.67%.结论 意识状态不稳定、侵袭操作、使用广谱抗生素、血压异常、心率异常、呼吸功能异常、感染均是导致更年期女性ICU住院时间延长的危险因素,临床上应密切关注并及时给予针对性治疗.
Risk factors and predictive model construction of prolonged stay in menopausal female patients in intensive care unit
Objective To explore the risk factors for prolonged stay of menopausal female patients in intensive care unit(ICU)and construct a predictive model.Methods A total of 260 menopausal women hospitalized in ICU of Taizhou Central Hospital from June 2019 to December 2022 were selected as study subjects.According to the length of ICU stay,the patients were divided into extended group(≥5d,156 cases)and non-extended group(<5d,104 cases).The clinical data of patients were collected,and the factors affecting the length of stay in ICU patients were analyzed by multivariate Logistic regression.A nomogram prediction model was constructed,receiver operating characteristic curve was drawn,and the area under the curve(AUC)was calculated.Results The proportion of coma,invasive operation and using of broad spectrum antibiotic in extended group were significantly higher than those in non-extended group(P<0.05).The incidence of abnormal blood pressure,muscle/bone joint pain,abnormal heart rate,abnormal respiratory function and infection in extended group were significantly higher than those in non-extended group(P<0.05).Multivariate Logistic regression analysis showed that coma,invasive operation,using of broad spectrum antibiotic,abnormal blood pressure,abnormal heart rate,abnormal respiratory function and infection were the risk factors leading to prolonged ICU stay in menopausal women(P<0.05).The constructed nomogram model had a good fit(χ2=5.072,P=0.285).The AUC of patients with prolonged ICU stay predicted by nomogram model was 0.857(95%CI:0.778-0.937),the sensitivity was 78.16%,and the specificity was 83.67%.Conclusion Unstable conscious state,invasive operation,using of broad spectrum antibiotic,abnormal blood pressure,abnormal heart rate,abnormal respiratory function,and infection are all risk factors leading to prolonged ICU stay in menopausal women,which should be paid close attention to and timely targeted treatment.
Intensive care unitMenopauseProlonged hospital stayRisk factorsPredictive model
国家科技期刊平台
NSTL
万方数据
