浙江医学2018，Vol.40Issue(16)：1843-1846,4.DOI:10.12056/j.issn.1006-2785.2018.40.16.2017-2294
ICU机械通气患者VAP早期预警模型的建立与效能评价
Establishment and evaluation of ventilator- associate pneumonia(VAP) early warning model for ICU patients with mechanical ventilation
邢飞 1董晓超 1张蕾1
作者信息
- 1. 130021 长春,吉林大学第一医院重症医学科
- 折叠
摘要
Abstract
Objective To establish and evaluate an early warning model of ventilator- associated pneumonia (VAP) for patients with mechanical ventilation in ICU. Methods The clinical data of 138 patients with VAP who underwent mechanical ventilation in ICU from June 2015 to June 2017 were enrolled in the study, and 120 patients who underwent mechanical ventilation and had no VAP served as the control group. SPSS software was used to analyze the univariate and multivariate logistic regression of the related factors. The early warning model of VAP for patients with mechanical ventilation in ICU was established according to the results of multivariate logistic regression analysis. The effectiveness of the early warning model was evaluated by ROC. Results Multivariate logistic regression analysis showed that duration of mechanical ventilation ≥6d, retention of gastric tube, APACHE II score ≥18, use of acidifiers, invasive manipulation and GCS≥7d were independent risk factors of VAP (all P＜ 0.05). A VAP early warning model Z=3.357+0.029 x gastric tube retention+0.174 x APACHE II score+0.957 x acidogenic agent+0. 632 x invasive operation+0.236 x GCS usage time was established. The area under ROC curve (AUC) of the model for predicting VAP was 0.919 (95％ CI: 0.877～0.971), with cut- off value of 0.331, the sensitivity and specificity were 0.9052 and 0.8149 with a Youden's index of 0.71. Conclusion The established early warning model may provide guidance for diagnosis and prevention of VAP in ICU patients with mechanical ventilation.关键词
ICU机械通气/呼吸机相关性肺炎/预警模型/效能评价Key words
ICU mechanical ventilation/Ventilator- associated pneumonia/Early warning model/Effectiveness evaluation引用本文复制引用
邢飞,董晓超,张蕾..ICU机械通气患者VAP早期预警模型的建立与效能评价[J].浙江医学,2018,40(16):1843-1846,4.
