目的 探讨医护联动综合评估在输液港感染患者预测模型构建中的应用效果。方法 选取2023年7月—2024年12月我院收治的550例输液港应用患者作为研究对象,将其中发生感染的50例患者作为感染组,未发生感染的500例患者作为非感染组。通过医护联动综合评估分析输液港感染患者发生的原因,采用单因素分析和logistic回归分析建立预测模型,并采用列线图进行可视化表达。结果 输液港感染患者发生的主要原因是肠外营养、妇科系统癌症、血液系统癌症、合并糖尿病、置管时间>110天（P<0.05）。预测模型的受试者工作特征（receiver operating characteristic,ROC）曲线下面积为0.851,对应的灵敏度为0.802,特异度为0.811,预测模型的实际值与预测值之间的平均绝对误差为0.011,校准曲线与理想曲线吻合度较高;Hosmer-Lemeshow拟合优度检验结果χ2=2.873（P=0.931）。结论 通过医护联动综合评估构建的预测模型具有良好的预测效果,可为临床工作人员早期识别输液港感染高风险患者提供重要参考。
Abstract
Objective To explore the application effect of joint medical-nursing assessment in the construction of a prediction model for port-related infections. Methods A total of 550 patients with port applications admitted to a tertiary hospital from July 2023 to December 2024 were selected as the subjects of this study, among whom 50 patients who developed infections were designated as the infection group, and 500 patients without infections were designated as the non-infection group. The reasons for infections in patients with port applications were analyzed through joint medical-nursing assessment. A prediction model was established using univariate analysis and logistic regression analysis, and a nomogram was used for visual expression. Results The main causes of infection in the infusion port were parenteral nutrition, gynecological system cancer, hematological system cancer, diabetes, and intubation time>110 days (P<0.05). The area under the ROC curve of the prediction model was 0.851, corresponding to a sensitivity of 0.802 and a specificity of 0.811. The average absolute error between the actual and predicted values of the prediction model was 0.011, indicating a high degree of agreement between the calibration curve and the ideal curve; the Hosmer-Lemeshow goodness-of-fit test result was χ2=2.873 (P=0.931). Conclusion The prediction model constructed through joint medical-nursing assessment has good predictive performance and can provide important reference for clinical staff to identify high-risk patients for port-related infections at an early stage.
关键词
医护联动综合评估 /
输液港 /
感染 /
预测模型
Key words
medical-nursing collaborative comprehensive assessment /
port-a-cath (implanted port) /
infection /
predictive model
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基金
沧州市重点研发计划项目“医护联动综合评估在输液港并发症预防中的应用研究”（213106046）
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