Risk factors analysis and nomogram construction of facial pressure injury related to ventilation in prone positioning in children with severe pneumonia
- VernacularTitle:重症肺炎患儿俯卧位通气相关面部压力性损伤发生风险因素分析及列线图构建
- Author:
Xiuling ZHAI
1
;
Yongxia WANG
;
Hui DING
;
Libing ZHANG
;
Mei LI
Author Information
- Keywords: severe pneumonia in children; prone positioning ventilation; facial pressure in-jury; influencing factors; nomogram model
- From: Journal of Clinical Medicine in Practice 2024;28(4):102-106
- CountryChina
- Language:Chinese
- Abstract: Objective To investigate the influencing factors of facial pressure injury related to ventilation in prone positioning in children with severe pneumonia and to construct a nomogram predic-tion model.Methods A total of 158 children with severe pneumonia who underwent prone positioning ventilation were selected as research subjects.Clinical data were collected,and the children were di-vided into injury group(31 cases)and non-injury group(127 cases)based on whether facial pressure injury occurred.Univariate and multivariate Logistic regression analysis were used to explore the influ-encing factors of facial pressure injury related to prone positioning ventilation in children with severe pneumonia;the receiver operating characteristic(ROC)curve,consistency index,and Hosmer-Leme-show goodness-of-fit test were used to evaluate the predictive efficiency of the nomogram model for facial pressure injury related to prone positioning ventilation in children with severe pneumonia.Results Un-ivariate analysis showed that the proportion of children aged＜3 years,the proportion of those with complications,ventilation time in prone positioning,the proportions of children with sedative drugs and poor nutritional status,no decompression dressings,and the proportions of children without prone posi-tioning ventilation training for medical staff in the injury group were higher or longer than that in the non-injury group(P＜0.05).Multivariate Logistic regression analysis showed that age＜3 years,presence of complications,longer prone positioning ventilation time,no decompression dressings,and lack of prone positioning ventilation training for medical staff were independent risk factors for facial pressure injury related to prone positioning ventilation in children with severe pneumonia(P＜0.05),and a nomogram prediction model was constructed based on these factors.The consistency index of the nomogram model was 0.940,and the area under the ROC curve was 0.978(95％CI,0.958 to 0.999).The calibration curve of predicting facial pressure injury related to prone positio-ning ventilation in children with severe pneumonia approached the ideal curve,and the Hosmer-Lemeshow goodness-of-fit test showed good fitting(x2=12.416,P＜0.05).Conclusion The no-mogram prediction model constructed based on 5 independent risk factors in this study has high risk identification ability and can early identify high-risk children with facial pressure injury related to prone positioning ventilation in severe pneumonia.
