Risk factors and visual prediction model for lower respiratory tract infection in patients with aneurysmal subarachnoid hemorrhage in emergency care unit
10.11816/cn.ni.2025-250386
- VernacularTitle:急诊监护病房动脉瘤性蛛网膜下腔出血患者下呼吸道感染危险因素及可视化预测模型
- Author:
Shuo LIU
1
;
Juan WU
1
Author Information
1. 南京医科大学第一附属医院(江苏省人民医院)急诊医学科监护二病区,江苏南京 210000
- Publication Type:Journal Article
- Keywords:
Aneurysmal subarachnoid hemorrhage;
Lower respiratory tract infection;
Risk factor;
Nomo-gram model;
Postoperative infection
- From:
Chinese Journal of Nosocomiology
2025;35(19):2935-2940
- CountryChina
- Language:Chinese
-
Abstract:
OBJECTIVE To explore the risk factors for lower respiratory tract infection(LRTI)in patients with an-eurysmal subarachnoid hemorrhage(aSAH)in the emergency care unit and to establish a nomogram model for LRTI in patients with aSAH.METHODS A total of 327 patients with aSAH admitted to the First Affiliated Hos-pital with Nanjing Medical University from Feb.2020 to Jul.2023 were enrolled as study subjects.Based on the presence of LRTI in patients with aSAH,they were divided into an LRTI group(n=79)and a no-LRTI group(n=248).Lasso analysis was used to screen predictive factors for LRTI in patients with aSAH.Logistic regres-sion was employed to identify risk factors for LRTI in patients with aSAH.The R software version 4.2.3 was uti-lized to develop and validate a nomogram model for LRTI in patients with aSAH.RESULTS Logistic regression a-nalysis revealed that the location of the responsible aneurysm in the posterior circulation(OR=2.568),Hunt-Hess grading(grades Ⅲ-Ⅳ)(OR=3.576),use of glucocorticoids(OR=2.983),invasive procedures(OR=3.190),history of chronic lung diseases(OR=3.214),disturbance of consciousness(OR=2.631)and diabetes(OR=2.419)were risk factors for LRTI in patients with aS AH(P＜0.05).Interaction analysis showed an addi-tive interaction existed between diabetes and the use of glucocorticoids on the risk of LRTI in patients with aSAH.The area under the receiver operating characteristic(ROC)curve of the nomogram model for LRTI in pa-tients with aSAH was 0.756(95％CI:0.691-0.821),and the calibratio n curve demonstrated good agreement between predicted and actual values.Decision curve analysis indicated that the nomogram provided good net benefit for predicting LRTI in patients with aSAH when the threshold probability ranged from 6％to 84％.CONCLUSIONS The nomogram model established based on seven risk factors,including location of the responsible aneurysm in the posterior circulation,Hunt-Hess grades Ⅲ-Ⅳ,use of glucocorticoids,invasive procedures,his-tory of chronic lung disease,disturbance of consciousness and diabetes,can effectively predict the risk of LRTI in patients with aSAH.
