PDF(Pubmed)
Abstract：
UNASSIGNED: This study aimed to explore the risk factors for failed treatment of carbapenem-resistant Acinetobacter baumannii ventilator-associated pneumonia (CRAB-VAP) with tigecycline and to establish a predictive model to predict the incidence of failed treatment and the prognosis of CRAB-VAP.
UNASSIGNED: A total of 189 CRAB-VAP patients were included in the safety analysis set from two Grade 3 A national-level hospitals between 1 January 2022 and 31 December 2022. The risk factors for failed treatment with CRAB-VAP were identified using univariate analysis, multivariate logistic analysis, and an independent nomogram to show the results.
UNASSIGNED: Of the 189 patients, 106 (56.1%) patients were in the successful treatment group, and 83 (43.9%) patients were in the failed treatment group. The multivariate logistic model analysis showed that age (OR = 1.04, 95% CI: 1.02, 1.07, p = 0.001), yes. of hypoproteinemia (OR = 2.43, 95% CI: 1.20, 4.90, p = 0.013), the daily dose of 200 mg (OR = 2.31, 95% CI: 1.07, 5.00, p = 0.034), yes. of medication within 14 days prior to surgical intervention (OR = 2.98, 95% CI: 1.19, 7.44, p = 0.019), and no. of microbial clearance (OR = 0.31, 95% CI: 0.14, 0.70, p = 0.005) were risk factors for the failure of tigecycline treatment. Receiver operating characteristic (ROC) analysis showed that the AUC area of the prediction model was 0.745 (0.675-0.815), and the decision curve analysis (DCA) showed that the model was effective in clinical practice.
UNASSIGNED: Age, hypoproteinemia, daily dose, medication within 14 days prior to surgical intervention, and microbial clearance are all significant risk factors for failed treatment with CRAB-VAP, with the nomogram model indicating that high age was the most important factor. Because the failure rate of CRAB-VAP treatment with tigecycline was high, this prediction model can help doctors correct or avoid risk factors during clinical treatment.
UNASSIGNED: A total of 189 CRAB-VAP patients were included in the safety analysis set from two Grade 3 A national-level hospitals between 1 January 2022 and 31 December 2022. The risk factors for failed treatment with CRAB-VAP were identified using univariate analysis, multivariate logistic analysis, and an independent nomogram to show the results.
UNASSIGNED: Of the 189 patients, 106 (56.1%) patients were in the successful treatment group, and 83 (43.9%) patients were in the failed treatment group. The multivariate logistic model analysis showed that age (OR = 1.04, 95% CI: 1.02, 1.07, p = 0.001), yes. of hypoproteinemia (OR = 2.43, 95% CI: 1.20, 4.90, p = 0.013), the daily dose of 200 mg (OR = 2.31, 95% CI: 1.07, 5.00, p = 0.034), yes. of medication within 14 days prior to surgical intervention (OR = 2.98, 95% CI: 1.19, 7.44, p = 0.019), and no. of microbial clearance (OR = 0.31, 95% CI: 0.14, 0.70, p = 0.005) were risk factors for the failure of tigecycline treatment. Receiver operating characteristic (ROC) analysis showed that the AUC area of the prediction model was 0.745 (0.675-0.815), and the decision curve analysis (DCA) showed that the model was effective in clinical practice.
UNASSIGNED: Age, hypoproteinemia, daily dose, medication within 14 days prior to surgical intervention, and microbial clearance are all significant risk factors for failed treatment with CRAB-VAP, with the nomogram model indicating that high age was the most important factor. Because the failure rate of CRAB-VAP treatment with tigecycline was high, this prediction model can help doctors correct or avoid risk factors during clinical treatment.
摘要：
■本研究旨在探讨替加环素治疗耐碳青霉烯鲍曼不动杆菌呼吸机相关性肺炎(CRAB-VAP)失败的危险因素，并建立预测CRAB-VAP失败发生率及预后的预测模型。
■在2022年1月1日至2022年12月31日期间，共有189名CRAB-VAP患者被纳入了来自两家国家三级甲等医院的安全性分析集。使用单因素分析确定CRAB-VAP治疗失败的危险因素。多变量逻辑分析，和一个独立的列线图来显示结果。
■在189名患者中，106例（56.1%）患者为成功治疗组，83例(43.9%)患者属于治疗失败组.多因素Logistic模型分析显示,年龄(OR=1.04,95%CI:1.02,1.07,p=0.001),是的。低蛋白血症（OR=2.43，95％CI：1.20，4.90，p=0.013），日剂量为200mg（OR=2.31，95％CI：1.07，5.00，p=0.034），是的。手术前14天内的药物治疗（OR=2.98，95%CI：1.19，7.44，p=0.019），和没有。微生物清除率(OR=0.31,95%CI:0.14,0.70,p=0.005)是替加环素治疗失败的危险因素.接收机工作特性(ROC)分析表明,预测模型的AUC面积为0.745(0.675-0.815),决策曲线分析(DCA)表明该模型在临床实践中是有效的。
■年龄，低蛋白血症,日剂量,在手术干预前14天内服药，和微生物清除都是CRAB-VAP治疗失败的重要危险因素，列线图模型表明，高年龄是最重要的因素。因为替加环素治疗CRAB-VAP的失败率高,该预测模型可以帮助医生纠正或避免临床治疗过程中的危险因素。
■在2022年1月1日至2022年12月31日期间，共有189名CRAB-VAP患者被纳入了来自两家国家三级甲等医院的安全性分析集。使用单因素分析确定CRAB-VAP治疗失败的危险因素。多变量逻辑分析，和一个独立的列线图来显示结果。
■在189名患者中，106例（56.1%）患者为成功治疗组，83例(43.9%)患者属于治疗失败组.多因素Logistic模型分析显示,年龄(OR=1.04,95%CI:1.02,1.07,p=0.001),是的。低蛋白血症（OR=2.43，95％CI：1.20，4.90，p=0.013），日剂量为200mg（OR=2.31，95％CI：1.07，5.00，p=0.034），是的。手术前14天内的药物治疗（OR=2.98，95%CI：1.19，7.44，p=0.019），和没有。微生物清除率(OR=0.31,95%CI:0.14,0.70,p=0.005)是替加环素治疗失败的危险因素.接收机工作特性(ROC)分析表明,预测模型的AUC面积为0.745(0.675-0.815),决策曲线分析(DCA)表明该模型在临床实践中是有效的。
■年龄，低蛋白血症,日剂量,在手术干预前14天内服药，和微生物清除都是CRAB-VAP治疗失败的重要危险因素，列线图模型表明，高年龄是最重要的因素。因为替加环素治疗CRAB-VAP的失败率高,该预测模型可以帮助医生纠正或避免临床治疗过程中的危险因素。
