Risk factors for MDRO lung infection in patients in the recovery phase of traumatic brain injury and the construction of a predictive model
10.11816/cn.ni.2025-241781
- VernacularTitle:脑外伤恢复期患者MDRO肺部感染危险因素及其预测模型构建
- Author:
Xuehong CHEN
1
;
Xuan ZHANG
1
;
Jiali WANG
1
;
Jianlin YANG
1
Author Information
1. 山西省第二人民医院医院感染管理科,山西太原 030012
- Publication Type:Journal Article
- Keywords:
Traumatic brain injury;
Multiple drug resistant organism infection;
Pneumonia;
Pathogen;
Prediction model
- From:
Chinese Journal of Nosocomiology
2025;35(11):1654-1659
- CountryChina
- Language:Chinese
-
Abstract:
OBJECTIVE To analyze pathogens of multiple drug-resistant organism(MDRO)infection and its risk factors during the recovery period of patients with traumatic brain injury,and to construct and validate the predic-tion model for MDRO lung infection.METHODS Patients who were admitted to the Shanxi Second People's Hos-pital for traumatic brain injury(TBI)and developed hospital-acquired pneumonia(HAP)during their hospitaliza-tion between Aug.2019 and Aug.2023 were selected as the study subjects,their clinical data were retrospectively collected,and the patients were randomly divided into a modeling group(n=270)and a verification group(n=90)at a ratio of 3∶1,and they were further categorized into the MDRO infection group(148 cases)and the non-infection group(122 cases)based on whether they developed pneumonia caused by MDRO infections.Clinical data of the patients were collected for analysis,with pathogen identification performed for all patients.The risk factors for MDRO infection in TBI patients with HAP were analyzed by multivariate Logistic regression analysis,a pre-diction model for MDRO infections during the hospitalization and recovery period of TBI patients with HAP was constructed using a formula-based method,the goodness-of-fit of the model was assessed using Hosmer-Leme-show test,and its predictive ability was evaluated using receiver operating characteristic(ROC)curves.RESULTS There was no significant differences in the baseline characteristics of TBI patients with HAP between the modeling group and the verification group.The incidence of MDRO infections among TBI patients with HAP in modeling group was 54.81％(148/270),with Klebsiella pneumoniae(25.27％)being the predominant pathogen.Mechan-ical ventilation duration(OR=5.789,95％CI:2.164-15.486,P=0.001),ICU length of stay(OR=5.441,95％CI:2.153-13.751,P＜0.001),combined kidney diseases(OR=2.770,95％CI:1.321-5.812,P=0.007),duration of antibiotics use(OR=7.486,95％CI:1.928-29.059,P=0.004),occurrence of impaired consciousness(OR=5.720,95％CI:2.586-12.652,P＜0.001)and use of aminoglycoside antibiotics(OR=3.861,95％CI:1.608-9.273,P=0.003)were risk factors for MDRO infections.The Hosmer-Lemeshow for the risk prediction model showed that x2=5.013 and P=0.496.ROC curves analysis showed The area under the curve(AUC)for the modeling group by ROC curve analysis was 0.80(95％CI:0.773-0.877),with a sensitivi-ty of 83.33％and a specificity of 73.60％respectively,and the AUC for the verification group were 0.800(95％CI:0.670-0.895),with a sensitivity of 81.82％and a specificity of 77.27％respectively.CONCLUSION The prediction model constructed in this study,based on the risk factors for MDRO infection pneumonia during the re-covery period in hospitalized patients with traumatic brain injury,demonstrated high goodness-of-fit,as well as satisfactory sensitivity and specificity,and its application in clinical practice may help identify patients at high risk of MDRO infections.
