分析一家癌症专科医院耐多药生物体 (MDRO) 感染的风险因素并构建风险预测模型。

IF 1 4区 医学 Q3 MEDICINE, GENERAL & INTERNAL British journal of hospital medicine Pub Date : 2024-10-30 Epub Date: 2024-10-27 DOI:10.12968/hmed.2024.0353
Chongwei Li, Linghui He, Junwei Xu, Lili Wang, Xiaoli Cao, Hui Zhang, Pingping Ma, Yongmei Yuan
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引用次数: 0

摘要

目的/背景 在癌症专科医院接受治疗的患者由于密集治疗和长期住院导致免疫力下降等因素,特别容易感染耐多药微生物(MDRO)。本研究旨在调查癌症专科医院环境中发生 MDRO 感染的风险因素,并建立相应的风险预测模型。方法 选择确诊感染 MDRO 的患者为 MDRO 感染组(n = 238),未感染 MDRO 的患者为非 MDRO 感染组(n = 238)。采用非参数检验、卡方检验和多变量逻辑回归分析来确定MDRO感染的主要风险因素。通过使用 R 软件 4.4.1(奥地利维也纳 R 统计计算基金会)进行分析,我们建立了一个提名图预测模型,并使用接收者操作特征(ROC)曲线、校准曲线和决策曲线分析(DCA)对该模型进行了评估。结果 年龄、抗生素应用时间和中心静脉导管插入术是 MDRO 感染的独立风险因素(P < 0.05)。所构建的 MDRO 感染患者提名图预测模型的 C 指数为 0.8640。ROC 曲线结果显示,预测模型的特异性为 0.7700,灵敏度为 0.8800,曲线下面积(AUC)为 0.8800。结论 本研究确定了在癌症专科医院环境中发生 MDRO 感染的重要风险因素,并提供了一个对临床有用的预测模型,该模型可能有助于采取有针对性的预防措施和优化抗生素的使用,从而有可能降低这些感染的发生率和影响。
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Analysis of Risk Factors for Multidrug-Resistant Organism (MDRO) Infections and Construction of a Risk Prediction Model in a Cancer Specialty Hospital.

Aims/Background Patients receiving treatment in specialized cancer hospitals are particularly susceptible to multidrug-resistant organisms (MDRO) infections due to factors such as weakened immune systems caused by intensive treatments and prolonged hospital stays. This study aims to investigate the risk factors for MDRO infections in the cancer specialty hospital setting and to develop a corresponding risk prediction model. Methods Patients diagnosed with MDRO infections were selected for the MDRO infection group (n = 238), and those without for the non-MDRO infection group (n = 238). Non-parametric tests, chi-square tests, and multivariate logistic regression analysis were used to identify the primary risk factors for MDRO infections. With the aid of analysis utilizing R software 4.4.1 (R Foundation for Statistical Computing, Vienna, Austria), we developed a nomogram prediction model, which was evaluated using the receiver operating characteristics (ROC) curve, calibration curve, and decision curve analysis (DCA). Results Age, antibiotic application time, and central venous catheterization were independent risk factors for MDRO infection (p < 0.05). The constructed nomogram prediction model for patients with MDRO infection has a C-index of 0.8640. The ROC curve results showed that the prediction model has a specificity of 0.7700, a sensitivity of 0.8800, and an area under the curve (AUC) of 0.8800. Conclusion This study identifies significant risk factors for MDRO infections in a cancer specialty hospital setting and offers a clinically useful prediction model, which may aid in targeted preventive measures and optimization of antibiotics usage, thereby potentially reducing the incidence and impact of these infections.

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来源期刊
British journal of hospital medicine
British journal of hospital medicine 医学-医学:内科
CiteScore
1.50
自引率
0.00%
发文量
176
审稿时长
4-8 weeks
期刊介绍: British Journal of Hospital Medicine was established in 1966, and is still true to its origins: a monthly, peer-reviewed, multidisciplinary review journal for hospital doctors and doctors in training. The journal publishes an authoritative mix of clinical reviews, education and training updates, quality improvement projects and case reports, and book reviews from recognized leaders in the profession. The Core Training for Doctors section provides clinical information in an easily accessible format for doctors in training. British Journal of Hospital Medicine is an invaluable resource for hospital doctors at all stages of their career. The journal is indexed on Medline, CINAHL, the Sociedad Iberoamericana de Información Científica and Scopus.
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