实用临床医药杂志2024，Vol.28Issue(8)：45-49,54,6.DOI:10.7619/jcmp.20234252
脑出血术后多重耐药感染风险的诺模图预测模型的构建与验证
Establishment and validation of a Nomogram prediction model for risk of multi-drug resistant infection after operation of cerebral hemorrhage
摘要
Abstract
Objective To investigate the risk factors for postoperative multi-drug resistant infection in patients with cerebral hemorrhage and establish a Nomogram prediction model.Methods Clinical materials of 241 patients with surgery for cerebral hemorrhage in the hospital from July 2020 to July 2023 were collected,and they were divided into infection group and non-infection group.Logistic re-gression models were used to analyze independent influencing factors for the occurrence of postopera-tive multi-drug resistant infection in patients with cerebral hemorrhage,and a Nomogram prediction model was constructed accordingly.The predictive performance of the Nomogram was evaluated by the consistency index(C-index),the receiver operating characteristic(ROC)curve,and the calibration curve.Results A total of 241 patients with cerebral hemorrhage were included in this study,among which 56 cases(24.24％)had postoperative multi-drug resistant infection.In the infection group,the preoperative Glasgow Coma Scale(GCS)score,ratio of preoperative vomiting,ratio of preopera-tive antibiotic treatment,ratio of gastric tube indwelling,ratio of tracheotomy,and ratio of intubation were significantly higher than those in the non-infection group(P＜0.05).Logistic regression analy-sis revealed that preoperative GCS score ≤ 8,preoperative vomiting,preoperative antibiotic treatment,gastric tube indwelling,tracheotomy and intubation were the independent risk factors for postoperative multi-drug resistant infection in patients with cerebral hemorrhage(OR＞1,P＜0.05).Values of ar-ea under thecurve(AUC)for preoperative GCS score,preoperative vomiting,preoperative antibiotic treatment,tracheotomy and intubation were all above 0.700,indicating these indicators have good predictive value for the occurrence of postoperative multi-drug resistant infection in such patients.Based on these influencing factors,a Nomogram risk model was established.The C-index value of the calibration curve was 0.798,suggesting the Nomogram model has good discriminatory power.The AUC values for the modeling group and validation group in the ROC curve were 0.798 and 0.722 respectively,indicating that the Nomogram model possesses satisfactory predictive efficacy.Conclusion Nomogram prediction model constructed based on independent risk factors for postop-erative multi-drug resistant infection in patients with cerebral hemorrhage can effectively predict the probability of such infections occurring in these patients after surgery.关键词
脑出血/多重耐药感染/危险因素/格拉斯哥昏迷量表/诺模图Key words
cerebral hemorrhage/multi-drug resistant infection/risk factors/the Glasgow Coma Scale/Nomogram分类
医药卫生引用本文复制引用
陈晖,张莉,陆晨,蔡新娣..脑出血术后多重耐药感染风险的诺模图预测模型的构建与验证[J].实用临床医药杂志,2024,28(8):45-49,54,6.基金项目
江苏省优势学科建设工程项目(YSHL0824-200) （YSHL0824-200）
