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Establishment and validation of nomogram model for prediction of peripherally inserted central venous catheter-related bloodstream infection risk |
TANG Qianyun XING Bo |
Department of ICU, the Second Affiliated Hospital of Hainan Medical University, Hainan Province, Haikou 570311, China |
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Abstract Objective To discuss the risk factors of peripherally inserted central catheter (PICC) related bloodstream infection (PBSI) in patients with PICC, and to establish and validate a nomogram model for predicting the risk of PBSI. Methods A total of 931 patients receiving PICC in the Second Affiliated Hospital of Hainan Medical University from January 2016 to January 2020 were selected as research objects. The patients were divided into PBSI group (63 cases) and non-PBSI group (868 cases) according to whether there was PBSI or not, and clinical characteristics were compared. Multiplicity logistic regression analysis was used to screen independent risk factors of PBSI. According to the results of regression analysis, the nomogram prediction model was established. Calibration curve and receiver operating characteristic curve (ROC) were used to evaluate the predictive effectiveness of the model. Results Multiplicity logistic regression analysis showed that diabetes mellitus, malignant tumor, hematopathy, parenteral nutrition, double lumen, additional devices, ICU stay, and the time of indwelling catheter were independent risk factors for PBSI in PICC patients (P < 0.05). The C-index of internal validation of nomogram model was 0.929. The average absolute error between the predicted risk of PBSI and the actual risk was 0.017. The area under the curve predicted by ROC curve nomogram model was 0.930. Conclusion The nomogram model established in this study for predicting the risk of PBSI in patients with PICC has good discrimination and accuracy, and has high clinical value.
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[1] 黄志有,田丹杏,李琼瑶,等.超声引导下腋静脉穿刺置入PICC导管的临床应用[J].中国医药导报,2018,15(28):78-80.
[2] 胡君娥,宋健.品管圈活动在降低患者PICC带管并发症发生率中的应用[J].中国医药导报,2015,12(35):126-131.
[3] 江文,曾登芬.PICC导管相关性血流感染风险因素与防护措施研究进展[J].中国护理管理,2015,15(2):218-221.
[4] 孟月燕,王鲁杰,胥桂英,等.经外周静脉置入中心静脉导管相关性血流感染调查分析[J].中华医院感染学杂志,2015,25(18):4211-4213.
[5] 姜变通,张彩云,张志刚,等.中国导管相关血流感染研究文献的可视化分析[J].中国感染控制杂志,2018,17(7):597-605.
[6] 高福来,谢长顺,张利利.基于血清Betatrophin水平的非酒精性脂肪肝列线图预测模型的建立与分析[J].中国医药导报,2019,16(10):103-106.
[7] 张超纪,刘剑州,马国涛,等.基于北京协和医院病例首页信息构建预测心脏术后深部胸骨伤口感染风险的列连图模型[J].中国医药导报,2019,16(33):178-180.
[8] 王琴,陈金,魏力.预防PICC导管相关感染临床实践指南的质量评价[J].护理学报,2019,26(21):46-50.
[9] 宋健,严妍,黄艳,等.肿瘤患者PICC导管相关血流感染危险因素的logistic回归分析[J].中国感染控制杂志,2018, 17(8):683-687.
[10] 赵玉玲,李静,梁飞红,等.肿瘤患者PICC导管相关性血流感染危险因素Logistic回归分析[J].广西中医药大学学报,2018,21(4):104-108.
[11] 马梦柯,张培莉.PICC相关并发症的影响因素及其护理[J].护理研究,2016,30(31):3854-3856.
[12] 叶冠军,孙雅儿,陆萍,等.行PICC患者血栓和相关性血流感染发生的影响因素研究[J].中华全科医学,2019, 17(6):1037-1041.
[13] 林熹,江湖,江滢,等.多学科团队在肿瘤化疗患者经外周静脉置入中心静脉导管管理中的应用[J].中国医药导报,2017,14(14):151-155.
[14] 黄立权,邱添,刘孜卓,等.经腋静脉穿刺可减少中心静脉导管相关性血流感染的发生[J].中华急诊医学杂志,2019,28(10):1305-1308.
[15] 段万石.肿瘤病人肠外营养导致中心静脉导管相关感染的研究进展[J].肠外与肠内营养,2016,23(2):116-119.
[16] 汪明月,童翠玲.血管内导管相关性血流感染的危险因素研究进展[J].临床护理杂志,2019,18(1):60-64.
[17] 童翠玲,周红.血管内导管相关血流感染的防护新进展[J].护士进修杂志,2019,34(3):259-262.
[18] 陆小平.分析导致PICC置管患者相关性血流感染的危险因素[J].临床医药文献电子杂志,2017,4(31):6000.
[19] 李元,朱曦,江智霞,等.白血病患者PICC相关性血流感染目标性监测及危险因素分析[J].中华医院感染学杂志,2017,27(20):4622-4625.
[20] 陈清,林素涵,黄跃跃,等.预测首次发作急性胰腺炎病情严重程度列线图的建立[J].中华胰腺病杂志,2019, 19(6):420-424.
[21] 贺丹,邓平,曹理言,等.急性脑卒中并发医院获得性肺炎发病风险的列线图模型[J].中华医院感染学杂志,2019, 29(12):1890-1895.
[22] 赵丽娟,王富艳,胡俊霞.预测腹部手术切口感染风险的列线图模型的建立[J].中华现代护理杂志,2018,24(14):1633-1638.
[23] 谢建芳,余剑珍.PICC维护技术在社区医院的推广应用[J].中华现代护理杂志,2018,24(26):3197-3200.
[24] 王青梅,陈梅,姜婷婷.患者参与质量控制降低PICC导管并发症发生率的效果[J].中华现代护理杂志,2015, 21(20):2409-2411.
[25] 尹哲,张翠萍,陈玲.肿瘤病人PICC风险管理现状与研究进展[J].护理研究,2019,33(19):3375-3379.
[26] 万光明,王懿,潘璐意,等.藻酸钙伤口敷料预防肺癌患者PICC穿刺部位并发症的临床效果[J].中国医药导报,2019,16(31):169-172. |
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