ICU肠外营养患者中心静脉导管相关血流感染病原学分析及预测模型构建
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男,硕士在读,学生

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山东省教育厅2019年高等学校青创人才引育计划立项项目(2019-205)


Pathogens and prediction model for central line-associated bloodstream infections in intensive care unit patients receiving parenteral nutrition
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    摘要:

    目的 探讨ICU肠外营养患者发生中心静脉导管相关血流感染的危险因素,为针对性干预提供参考。方法 将ICU 987例经中心静脉导管进行肠外营养的患者分为建模组708例、验证组279例,通过单因素和多因素分析危险因素并构建预测模型。结果 建模组708例中85例(12.01%)发生血流感染,病原菌以革兰阳性菌为主(占53.98%)。筛选出APACHEⅡ评分、拔管时最高体温、白蛋白含量、营养液中加入谷氨酰胺、导管留置时间、肠外营养时间6项影响因素(均P<0.05),构建风险预测模型。预测曲线和观察曲线具有较好的一致性,建模组及验证组ROC曲线下面积分别为0.816和0.847。结论 该模型能较好地预测ICU肠外营养患者发生中心静脉导管相关血流感染风险,可为预防性管理提供参考。

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    Objective To investigate the risk factors for central venous catheter-related bloodstream infections (CRBSIs) in intensive care unit (ICU) patients receiving parenteral nutrition (PN) and to provide reference for targeted interventions. Methods A total of 987 ICU patients receiving PN via central venous catheter were divided into a modeling group (n=708) and a validation group (n=279), and risk factors were identified through univariate and multivariate analysis for development of a prediction model. Results CRBSIs were observed in 85 patients (12.01%) in the modeling group, with Gram-positive bacteria being the predominant pathogens (accounting for 53.98%). A risk prediction model was constructed by selecting six influencing factors:APACHE Ⅱ score, highest temperature at extubation, serum albumin level, use of glutamine-supplemented PN, duration of catheterization, and PN duration (all P<0.05). The predictive curve demonstrated good consistency with the observed curve, and the area under the ROC curve was 0.816 and 0.847 for the modeling group and validation group, respectively. Conclusion The model can better predict the risk of CRBSIs in ICU patients receiving PN, and can provide a reference for preventive management.

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孙宁鑫,贾维慧,宋艳梅,李春莲,刘晨,宋宜芬,厉丹阳,尹崇高. ICU肠外营养患者中心静脉导管相关血流感染病原学分析及预测模型构建[J].护理学杂志,2023,28(20):89-92

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  • 收稿日期:2023-05-05
  • 最后修改日期:2023-07-03
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  • 在线发布日期: 2023-12-29