Objective To develop predictive models based on decision tree and logistic regression algo-rithms for pulmonary multidrug-resistant organism(MDRO)infection risk in intensive care unit(ICU)pa-tients,and compare their predictive performance to provide references for pulmonary MDRO infection preven-tion.Methods A total of 350 ICU patients admitted to the hospital from January 2021 to December 2023 were enrolled and divided into an infection group(n=52)and a non-infection group(n=298)based on the pres-ence of pulmonary MDRO infection.Clinical data from both groups were collected and analyzed to identify risk factors for pulmonary MDRO infection in ICU patients.Using the risk of pulmonary MDRO infection in ICU patients as the dependent variable and the indicators with statistically significant differences in univariate anal-ysis as the independent variables,predictive models for pulmonary MDRO infection risk were developed by u-sing decision tree algorithms and logistic regression analysis.The predictive performance of these two models was compared.Results There were statistically significant differences(P＜0.05)between the infection and non-infection groups in terms of age,history of diabetes,hospital stay≥2 weeks,indwelling urinary catheter,chlorine dioxide disinfection,prolonged bedridden status,and disturbance of consciousness.Logistic regression analysis with pulmonary MDRO infection risk in ICU patients as the dependent variable showed that age ≥60 years,indwelling catheter,hypoproteinemia,and disturbance of consciousness were risk factors for pulmonary MDRO infection in ICU patients,while chlorine dioxide disinfection was a protective factor.Based on these risk factors and regression coefficients,the original warning model was established as:logit(P 1)=0.856 × age+0.928 × indwelling catheter+0.916 × chlorine dioxide disinfection+0.866× hypoproteinemia+0.986 × disturbance of consciousness-4.371.The Hosmer-Lemeshow test indicated good model fit(coefficient of de-termination R2=0.579,P=0.531).The decision tree model for pulmonary MDRO infection risk in ICU pa-tients constructed using decision tree algorithm comprised 4 layers and 9 nodes,selecting four clinical features as nodes:presence of consciousness disturbance,indwelling catheter,hypoproteinemia,and age≥60 years,with consciousness disturbance being the most significant predictor.The decision tree model showed an area under the curve(AUC)of 0.892(95％CI:0.835-0.949)on receiver operating characteristic(ROC)analy-sis,compared to 0.862(95％CI:0.812-0.912)for the logistic regression model.Delong test revealed no sig-nificant difference in predictive performance between the two models(Z=1.148,P=0.095).Conclusion Both the decision tree model and logistic regression model established for predicting the risk of pulmonary MDRO infection in ICU patients demonstrate high predictive performance with comparable efficacy.

The correct thoughts and principles of diagnosis and treatment of chronic refractory wounds need to be formulated. Through the relevant domestic and international consensus and based on clinical experience, the Thoughts and principles of diagnosis and treatment of chronic refractory wounds in China is proposed. It is considered that in the diagnosis and treatment of chronic refractory wounds, in the case of fully understanding the patient′s medical history, the following thoughts and principles should be complied in order. (1) Pay attention to the cleanliness of the wound after being cleaned. (2) Reasonably perform debridement to avoid being " excessive" or " not thorough". (3) Reasonably perform examination, diagnosis, and differential diagnosis of pathogenic factors. (4) Treat according to etiology. (5) Find comorbidities and prevent adverse outcomes. (6) Select the correct wound treatment method reasonably and timely. When the conservative wound care treatment is considered, pay attention to embodying the concept of etiological treatment, treat the wound according to the principles of safety, phase, selectivity, and effectiveness, and make a reasonable choice of continuing conservative treatment or surgical treatment in time after completing the preparation of the wound bed. When surgical treatment is considered, pay attention to the selection of reasonable surgical method and donor site, pay attention to the healing rate of surgical wound site and the outcome of donor site, and give reasonable protection to the wound site after surgery. (7) Carry out rehabilitation treatment after wound healing and related health education.