疑难病杂志2023，Vol.22Issue(12)：1245-1250,6.DOI:10.3969/j.issn.1671-6450.2023.12.003
脓毒症相关性脑病发生的影响因素及其列线图风险模型构建
Factors influencing the occurrence of sepsis related encephalopathy and the construction of a risk model using a col-umn chart
摘要
Abstract
Objective To explore the influencing factors of sepsis associated encephalopathy(SAE)and construct a column chart model to predict the occurrence of SAE.Methods Select 213 patients with sepsis admitted to the Intensive Care Unit(ICU)of Guizhou Medical University Affiliated Hospital from March 2021 to February 2023,and divide them into SAE group and non SAE group based on the occurrence of SAE.Collect various data for single factor analysis,and con-duct logistic regression analysis on the relevant factors of SAE occurrence;Use R software to construct a risk prediction model for SAE occurrence,and verify the discrimination and accuracy of the model through the area under the ROC cutve(AUC)and calibration curve.Results Among 213 patients with sepsis,84(39.44％)had SAE;SAE group APACHE Ⅱ score,SOFA score,middle cerebral artery PI,arterial blood lactate(BLA),serum S100 β、The levels of ALT,AST,IL-6,and the proportion of invasive mechanical ventilation were higher in the non SAE group than in the non SAE group(t(x2)/P=3.974/＜0.001,3.066/0.002,4.610/＜0.001,5.528/＜0.001,4.750/＜0.001,9.024/＜0.001,2.810/0.005,5.063/＜0.001,7239/0.007),lo-cal brain tissue oxygen saturation(rScO2)and albumin levels were lower than those in the non SAE group(t/P=4.935/＜0.001,3.650/＜0.001);The logistic regression analysis results showed that the main risk factors for the occurrence of SAE were high APACHE II score,high SOFA score,high middle cerebral artery PI,high arterial blood lactate,and high ALT,while high rScO2 and albumin were protective factors for the occurrence of SAE[OR(95％CI)=2.347(1.316～4.184),2.416(1.432～4.077),2204(1234～3.937),2.311(1306～4.088),2.326(1.376～3.933),0.468(0.271～0.809),0.561(0.342～0.919)];A column chart risk model was constructed based on 7 prediction indicators to predict the occurrence of SAE.The results showed that the AUC was 0.831(95％CI 0.773～0.889),and the probability of predicting SAE occurrence was similar to the actual probability,with a goodness of fit HL test x2=6282,P=0.616.Conclusion The column chart risk model construc-ted based on seven indicators:APACHE Ⅱ score,SOFA score,middle cerebral artery PI,rScO2,arterial blood lactate,ALT,and albumin has a good predictive effect on the occurrence of SAE.关键词
脓毒症相关性脑病/影响因素/预测/列线图风险模型Key words
Sepsis-associated encephalopathy/Influencing factors/Prediction/Column chart risk model分类
医药卫生引用本文复制引用
周航向,袁佳,张倩,陶浚泠,刘颖..脓毒症相关性脑病发生的影响因素及其列线图风险模型构建[J].疑难病杂志,2023,22(12):1245-1250,6.基金项目
贵州医科大学附属医院2021年度院级临床研究课题项目(2021-GMHCT-015)The Affiliated Hospital of Guizhou Medical University 2021 Clinical Research Project(2021-GMHCT-015) （2021-GMHCT-015）
