中国感染控制杂志2023，Vol.22Issue(12)：1483-1492,10.DOI:10.12138/j.issn.1671-9638.20233819
神经外科术后颅内感染Nomogram模型的建立与验证
Construction and validation of a Nomogram model of intracranial infection after neurosurgery
摘要
Abstract
Objective To explore the risk factors for intracranial infection in patients after neurosurgery,con-struct and validate a Nomogram prediction model.Methods Data of 978 patients who underwent neurosurgery in a hospital in Nanjing from January 1,2019 to December 31,2022 were retrospectively analyzed.Independent risk fac-tors were screened through logistic univariate and multivariate analyses.Modeling variables were screened through Lasso regression.A Nomogram model was constructed and internally validated by logistic regression.Effectiveness of the model was evaluated with receiver operating characteristic(ROC)curve,calibration curve and decision curve.Results Among 978 patients underwent neurosurgery,293 had postoperative intracranial infection,with an inci-dence of healthcare-associated infection of 29.96％.There was no significant difference in age,gender,proportion of coronary heart disease,cerebral infarction,diabetes and hypertension between the infected group and the non-in-fected group(all P＞0.05).Multivariate logistic analysis showed that postoperative intracranial hypertension,fe-ver,increased neutrophil percentage in blood routine examination,turbid cerebrospinal fluid,positive Pan's test,decreased glucose concentration,abnormal ratio of cerebrospinal fluid/serum glucose,positive microbial culture,absence of indwelling external ventricular drainage tubes,presence of indwelling lumbar cistern drainage tubes,use of immunosuppressive agents,and long duration of surgery were independent risk factors for postoperative intracra-nial infection in patients who underwent neurosurgery(all P＜0.05).Fifteen variables were screened out through Lasso regression.Fourteen variables were finally included for modeling after collinear screening,missing data impu-tation(random forest method)and checking pairwise interaction items.A Nomogram prediction model was con-structed,with the area under ROC curve,sensitivity,specificity,and accuracy of 0.885,0.578,0.896,and 0.704,respectively.Internal validation of the model was conducted.The modeling and validation groups presented similar effects.The calibration curve and decision curve also indicated that the model had good predictive efficacy.Conclusion The constructed Nomogram prediction model for postoperative intracranial infection after neurosurgery is scientific,and the prediction indicators are easy to obtain.The model presents with high stability,reliability,and application value,thus can provide reference for the assessment of postoperative intracranial infection after neuro-surgery.关键词
神经外科手术/颅内感染/危险因素/Nomogram/预测模型/手术部位感染Key words
neurosurgery/intracranial infection/risk factor/Nomogram/prediction model/surgical site infection分类
医药卫生引用本文复制引用
马小菊,张永祥,张卫红,李占结,俞英,卢岩,李松琴,刘娟,王峥,臧凤,黄慧萍,陈友鹏..神经外科术后颅内感染Nomogram模型的建立与验证[J].中国感染控制杂志,2023,22(12):1483-1492,10.基金项目
江苏省医院协会医院管理创新研究课题(JSYGY-3-2023-559) （JSYGY-3-2023-559）
江苏省人民医院第三期优秀中青年人才培养项目(YN-RCQN0314) （YN-RCQN0314）
南京医科大学第一附属医院青年基金培育计划(PY2022017) （PY2022017）
