摘要
Abstract
Objective To investigate the construction of risk prediction model and prevention strategy of fungal infection in cardiovascular surgical care unit.Methods A retrospective analysis was performed on 178 patients in the cardiovascular sur-gical care unit of the First Affiliated Hospital of the PLA Air Force Military Medical University from May 2020 to August 2023.Among them,41 had fungal infection and 137 did not.The clinical data of the two groups were collected,the risk fac-tors were analyzed by logistic regression model,the risk prediction model was constructed by the probability value fitted by the regression equation,and the correlation was evaluated by Pearson correlation coefficient.Results Among 41 patients with fungal infection,49 strains were detected,29 of which were Candida albicans,accounting for 59.18％.Multivariate logistic regression shows:Secondary tracheal intubation (OR=0.031),intensive care unit care time (OR=8.719),antibiotic use time (OR=2.785),acute physiology and chronic health evaluation Ⅱ (APACHE Ⅱ) (OR=2.060),procalcitonin (PCT) (OR=2.460),interleutin-6 (IL-6) (OR=1.044) were important influencing factors of fungal infections in the cardi-ovascular surgical care unit important influencing factors (P<0.05).Lymphocyte count (LYM) (OR=0.005) and albu-min (ALB) (OR=0.860) were protective factors for fungal infection in the CVD (P<0.05).Pearson correlation coefficient showed that there was a significant positive correlation between APACHE Ⅱ and PCT (r=0.383,P<0.001),but no sig-nificant correlation between APACHE Ⅱ and IL-6 (r=0.056,P=0.454).receiver operating characteristic curve (ROC) a-nalysis showed that the area under curve (AUC) of fungal infection in CVD was 0.996,95％CI was 0.911～1.000,sensi-tivity was 0.976,specificity was 0.985,and there were significant differences compared with Az=0.5 (P<0.05).Pearson correlation coefficient showed that fungal infection in CSCU was positively correlated with secondary tracheal intubation,in-tensive care unit care time,antibiotic use time,APACHE Ⅱ,PCT and IL-6 (P<0.05),and negatively correlated with LYM and ALB (P<0.05).Conclusion Secondary tracheal intubation,intensive care unit care time,antimicrobial drug use time,APACHE Ⅱ,PCT,IL-6 are important factors affecting fungal infection in the cardiovascular surgical care unit,LYM and ALB are protective factors,and the relevant factors should be evaluated for targeted prevention strategies.关键词
心血管外科监护室/真菌感染/监护病房/危险因素/预测Key words
cardiac surgical care unit/fungal infection/intensive care unit/risk factors/forecast分类
医药卫生
