Construction of risk prediction model for neonatal nosocomial infection risk factors
10.3760/cma.j.issn.1673-4912.2024.08.007
- VernacularTitle:新生儿医院感染危险因素的风险预测模型构建
- Author:
Jin LI
1
;
Xiuyue ZHANG
Author Information
1. 中国医科大学附属盛京医院院内感染管理办公室，沈阳 110004
- Keywords:
Newborn;
Nosocomial infection;
Risk factors;
Risk prediction model
- From:
Chinese Pediatric Emergency Medicine
2024;31(8):592-596
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To analyze the risk factors of neonatal nosocomial infection and establish a risk prediction model.Methods:The medical records of patients in the neonatal ward of Shengjing Hospital of China Medical University in 2023 were collected and divided into infection group and non-infection group according to whether nosocomial infection occurred. Univariate analysis was used to compare the differences of related factors between two groups. Multivariate Logistic regression analysis was used to screen the independent risk factors of neonatal nosocomial infection and construct the risk prediction model. The predictive value of the model was analyzed by receiver operating characteristic curve.Results:A total of 3 487 neonates were included in the study, including 1 881 males and 1 606 females. The median gestational age was 35 (32,38) weeks, and the median birth weight was 2 470(1 760,3 200) g. There were 158 cases in infection group and 3 329 cases in non-infection group. The main types of nosocomial infection were neonatal septicemia (142 cases,85.5%), central venous catheter-related infection (13 cases, 7.8%) and respiratory tract infection (eight cases, 4.8%). The main pathogens were Klebsiella pneumoniae (50 strains, 29.8%), Escherichia coli (26 strains, 15.5%)，and Staphylococcus epidermidis (25 strains, 14.9%). The independent risk factors of neonatal nosocomial infection were low birth weight ( OR=0.999,95% CI 0.999-1.000, P=0.039), central venous catheter placement ( OR=2.122, 95% CI 1.359-3.315, P=0.001), tracheal intubation ( OR=3.241, 95% CI 1.811-5.798, P<0.001)，and parenteral nutrition ( OR=11.087,95% CI 3.696-33.258, P<0.001). The regression equation of the established risk prediction model was Logit( P) =-47.407-0.001× birth weight +0.752× central venous catheter placement +1.176× tracheal intubation +2.406× parenteral nutrition. The area under the receiver operating characteristic curve was 0.870, the sensitivity was 89.2%, and the specificity was 76.0%,respectively. Conclusion:The risk prediction model of low birth weight, central venous catheter placement, tracheal intubation and parenteral nutrition is a good predictor of neonatal nosocomial infection and has certain clinical application value.
