一项电子健康记录广泛关联研究,以确定患有大肠杆菌血流感染风险较高的人群
Emma Pritchard1, Karina-Doris Vihta2, Samuel Lipworth3
1Division of Informatics, Imaging & Data Sciences, School of Health Sciences, University of Manchester, UK; Nuffield Department of Medicine, University of Oxford, Oxford, UK; The National Institute for Health Research Health Protection Research Unit in Healthcare Associated Infections and Antimicrobial Resistance at the University of Oxford, Oxford, UK.
电子医疗记录范围的关联研究表明,大肠杆菌病主要是由已知的危险因素和脆弱性驱动的. 针对可修改的风险,特别是脏和泌尿系统疾病,可以显著降低感染率.
科学领域:
- 医疗信息学
- 传染病流行病学
- 公共卫生监测
背景情况:
- 尽管英国有15年的强制性监测,但大肠杆菌病例仍在增加.
- 电子医疗记录 (EHR) 为识别感染驱动因素提供了丰富的数据来源.
- 一个全EHR关联研究 (EHR-WAS) 方法可以揭示被低估的风险因素.
研究的目的:
- 使用EHR-WAS识别大肠杆菌病的潜在危险因素.
- 量化发现的风险因素对感染率的影响.
- 为减少大肠杆菌血症提供有针对性的干预措施.
主要方法:
- 使用来自英国牛津郡的EHR数据,用于三个两年财政年度.
- 采用来自COVID-19研究的EHR-WAS研究方法.
- 通过Poisson回归分析了大肠杆菌病例,医院对照和377个潜在风险因素之间的关联.
主要成果:
- 六个广泛的疾病区域与大肠杆菌病的风险有关.
- 脏/尿道/尿道感染因素显示出最大的影响,可能减少47%的病例.
- 癌症,胃肠道和传染病因素增加了风险,而心脏/呼吸系统因素降低了风险.
结论:
- 大肠杆菌病主要是由已知的危险因素和患者的脆弱性驱动的.
- 通过EHR-WAS方法有效地确定了关键的关联.
- 监测和向可修改的风险因素,特别是脏和泌尿系统疾病,对于感染控制至关重要.
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