风险因素和预测模型构建对于外围插入的中央导管相关的感染
Wei Li1, Jing Cao1, Yu-Luo Du1
1Department of Critical Care Medicine, Shenzhen People's Hospital, Shenzhen, Guangdong, 518020, China.
Heliyon
|April 22, 2024
概括
从外围插入的中央导管 (PICC) 预测血液感染至关重要. 关键的危险因素包括年龄,导管运动,长时间的维护,插入技术,免疫状况,并发症和安置前发烧.
科学领域:
- 医学科学 医学科学 医学科学
- 传染性疾病 传染性疾病
- 临床流行病学 临床流行病学
背景情况:
- 周边插入的中央导管 (PICC) 广泛使用,但与血液感染有关.
- 预测建模可以帮助识别患有PICC相关感染高风险的患者.
研究的目的:
- 开发PICC患者血液感染风险的预测模型.
- 确定与PICC相关感染相关的独立风险因素.
主要方法:
- 对接受PICC治疗的505名患者进行了回顾性研究.
- 使用最小绝对收缩和选择操作员 (LASSO) 回归来进行预测选.
- 采用多变量逻辑回归,并构建了一个用于风险预测的名图.
- 使用接收器操作特征 (ROC) 曲线分析评估模型性能.
主要成果:
- 总共有75名患者 (14.85%) 患上了与PICC相关的感染,主要是由型阳性菌引起的.
- 确定了独立的风险因素:年龄>60岁,导管运动,维护周期>7天,直接插入技术,免疫功能低下,并发症和体温在安置前≥37.2°C.
- 命名图实现了0.889的ROC曲线下的面积,表明中等的预测值.
结论:
- 与PICC相关的感染是多因素的,受患者特异性和设备相关因素的影响.
- 开发的预测模型在识别患有PICC相关血流感染风险的患者方面表现出适度的有效性.
- 对已识别的风险因素进行临床警对于感染预防策略至关重要.
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