李贤英;丁克元;王捷;

• 1:芜湖市第五人民医院呼吸内科

摘要(Abstract)：

目的 建立长期气管切开患者肺部感染风险个体化预测的列线图模型，并评估模型的预测价值。方法 回顾性分析2018年1月-2022年1月芜湖市第五人民医院收治的75例长期气管切开并发肺部感染患者及同期230例长期气管切开无肺部感染患者临床资料，行单因素及多因素Logistic回归分析，筛选长期气管切开患者肺部感染独立危险因素，利用R软件建立预测长期气管切开并发肺部感染风险的列线图模型，采用Boot-strap法验证模型，受试者工作特征(ROC)曲线分析列线图模型预测肺部感染的价值。结果 多因素Logistic回归分析显示，合并糖尿病、原发性疾病为肺部疾病、吸烟史、意识障碍、低蛋白血症、气管切开前7 d内经常误吸、气道湿化不足/过度是长期气管切开患者并发肺部感染的危险因素。根据筛选的危险因素绘制列线图模型，R软件计算结果显示，列线图模型一致性指数(C-index)为0.811,预测能力良好。ROC曲线结果提示该列线图模型在预测长期气管切开患者肺部感染中的价值较高，曲线下面积为0.862 (95%CI:0.792～0.932)灵敏度为85.0%,特异度为81.7%。结论 基于糖尿病、原发性疾病为肺部疾病、吸烟史、意识障碍、低蛋白血症、气管切开前7d内经常误吸、气道湿化不足/过度7项独立危险因素建立的列线图模型可有效预测长期气管切开患者肺部感染发生风险。

关键词(KeyWords)： 个体化预测;气管切开;肺部感染;列线图模型;危险因素

Abstract:

Keywords:

基金项目(Foundation): 安徽省科技厅项目(1607a0202055)

作者(Authors): 李贤英;丁克元;王捷;

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