临床误诊误治2026，Vol.39Issue(2)：76-84,9.DOI:10.3969/j.issn.1002-3429.2026.02.012
ICU老年重型颅脑损伤患者口腔黏膜压力性损伤风险预测模型的构建及预测价值
Construction and predictive value of risk prediction model for the oral mucosal membrane pressure injury in elderly patients with severe traumatic brain injury in ICU
摘要
Abstract
Objective To construct a risk prediction model for the oral mucosal membrane pressure injury(MMPI)in elderly patients with severe traumatic brain injury(TBI)admitted to the intensive care unit(ICU),and to evaluate its predictive value.Methods A total of 100 elderly patients who developed oral MMPI while admitted to the ICU for severe TBI from January 2019 to February 2024 were selected as the observation group,and another 100 elderly patients who were admitted to the ICU for severe TBI during the same period but did not develop oral MMPI were selected as the control group.Baseline data for both groups were collected to analyze the influencing factors of oral MMPI in elderly ICU patients with severe TBI,the risk prediction model was constructed,and its predictive value was evaluated.Results Compared with the control group,the observation group had older age,the longer ICU stay and endotracheal tube indwelling time,higher proportions of the modified Beck oral assessment scale(BOAS)score of 11-15,combined diseases,the types of medical devices used ≥ 3,prone position ventilation,elevated skin temperature,sputum suction frequency interval＜2 h,use of vasoactive drugs,poor nutritional state,use of sedative drugs and higher levels of TNF-α and IL-6(P＜0.05,P＜0.01).Lasso-logistic regression analysis showed that the influencing factors of oral MMPI in elderly patients with severe TBI in ICU were age,length of ICU stay,combined diabetes mellitus,prone position ventilation,tracheal tube indwelling time,types of medical devices used,modified BOAS score,sputum suction frequency,use of vasoactive drugs and sedatives,nutritional status,TNF-α and IL-6.The concordance index(C-index)of the risk prediction model based on the above influencing factors was 0.894,and the area under the curve(AUC)was 0.815.The decision curve analysis(DCA)showed that the model achieved a favorable net benefit value.Conclusion Age,length of ICU stay,diabetes mellitus,prone position ventilation,endotracheal tube indwelling time,types of medical devices used,modified BOAS score,sputum suction frequency,use of vasoactive drugs and sedatives,nutritional status,TNF-α and IL-6 are the influencing factors of oral MMPI in elderly patients with severe TBI in ICU.The risk prediction model based on this has high prediction efficiency,and clinical prevention and treatment measures can be formulated according to the above influencing factors.关键词
重症监护病房/老年/口腔/黏膜压力性损伤/影响因素/风险预测模型Key words
intensive care unit/elderly/oral/mucosal membrane pressure injury/influencing factor/risk prediction model引用本文复制引用
钱程,包颖,李霞..ICU老年重型颅脑损伤患者口腔黏膜压力性损伤风险预测模型的构建及预测价值[J].临床误诊误治,2026,39(2):76-84,9.基金项目
江苏省2021年度开放课题立项课题(JSHH2021106) （JSHH2021106）
2019年度南通市市级科技计划(指导性)立项项目(MSZ19123) （指导性）
