沈阳医学院学报2026，Vol.28Issue(3)：257-263,281,8.DOI:10.16753/j.cnki.1008-2344.2026.03.006
气管切开长期机械通气老年患者肺部感染的nomogram模型构建
Construction of a nomogram model for pulmonary infection in elderly patients undergoing long-term mechanical ventilation via tracheotomy
摘要
Abstract
Objective:To investigate the influencing factors of pulmonary infection in elderly patients undergoing long-term mechanical ventilation via tracheotomy,and to construct a nomogram model.Methods:A total of 146 elderly patients who underwent long-term mechanical ventilation via tracheostomy at the Second Affiliated Hospital of Nanchang University from Apr 2023 to Nov 2024 were selected as the training set.These patients were divided into the infection group(n=41)and the non-infection group(n=105)based on the presence or absence of pulmonary infection.Multivariate logistic regression analysis was used to analyze the factors influencing the occurrence of pulmonary infection,and a nomogram model was constructed.Another 63 elderly patients who underwent long-term mechanical ventilation via tracheotomy from Nov 2024 to Jul 2025 were selected as the validation set.The predictive performance was verified through receiver operating characteristic(ROC)curves and calibration curves,and validation was conducted using the validation set data.Results:Multivariate logistic regression analysis showed that acute physiology and chronic health evaluation Ⅱ(APACHE Ⅱ)score,malnutrition,duration of antibiotic use,hypersensitive C-reactive protein(hs-CRP)level,albumin(ALB)level,combined hyperlipidemia,and combined diabetes were independent influencing factors of pulmonary infection in elderly patients undergoing long-term mechanical ventilation via tracheotomy(P＜0.05).The area under the ROC curve(AUC)of the training set was 0.905,with an optimal cutoff value of 0.346,sensitivity of 80.5%,and specificity of 88.6%,indicating good discrimination.The mean absolute error(MAE)was 0.027,demonstrating good calibration performance and strong reliability.The external predictive performance of the model in the validation set was also good.Conclusions:The APACHE Ⅱ score,malnutrition,duration of antibiotic use,hs-CRP level,ALB level,combined hyperlipidemia,and combined diabetes are independent risk factors for pulmonary infection in elderly patients undergoing long-term mechanical ventilation via tracheotomy.The constructed nomogram model exhibits good predictive performance.关键词
老年患者/气管切开/长期机械通气/肺部感染/nomogram模型Key words
elderly patients/tracheotomy/long-term mechanical ventilation/pulmonary infection/nomogram model分类
医药卫生引用本文复制引用
杨芬芳,王海燕,余丽娜,习苏园,舒苹,刘颜颜..气管切开长期机械通气老年患者肺部感染的nomogram模型构建[J].沈阳医学院学报,2026,28(3):257-263,281,8.基金项目
江西省卫生健康委科技计划(No.20203317) （No.20203317）
