■建立与外周插入中心导管(PICC)相关的血流感染风险的预测模型。
■回顾性纳入2020年6月至2020年12月在深圳市人民医院接受PICC治疗的患者,根据有无PICC相关性感染分为感染组和非感染组。然后,收集患者的相关临床资料,采用最小绝对收缩和选择算子回归(LASSO)模型筛选PICC相关感染的预测因子.此外,采用多因素logistic回归分析PICC相关感染的影响因素,根据多变量分析的结果构建列线图。最终,绘制受试者工作特征(ROC)曲线,分析影响因素在预测PICC相关感染中的应用价值。
■共纳入505名患者,包括75例PICC相关感染患者(14.85%)。主要病原菌为革兰氏阳性球菌。LASSO筛选的预测因素包括年龄>60岁,导管运动,导管维护周期,插入技术,免疫功能,并发症,PICC置管前体温≥37.2°C。多因素logistic回归分析显示,PICC相关感染的独立危险因素包括年龄>60岁[比值比(OR)=1.722;95%置信区间(CI)=1.312~3.579;P=0.006]。导管移动(OR=1.313;95%CI=1.119-3.240;P=0.014),导管维持周期>7天(OR=2.199;95%CI=1.677-4.653;P=0.000),直接插入(OR=1.036;95%CI=1.019-2.743;P=0.000),免疫功能低下(OR=2.322;95%CI=2.012-4.579;P=0.000),并发症(OR=1.611;95%CI=1.133-3.454;P=0.019),PICC置管前体温≥37.2°C(OR=1.713;95%CI=1.172-3.654;P=0.012)。此外,ROC曲线下面积为0.889.
■PICC相关感染与年龄>60岁等因素有关,导管运动,导管维护周期,插入技术,免疫功能,并发症,PICC置管前体温≥37.2°C。此外,LASSO模型对PICC相关感染的发生具有中度预测作用.
UNASSIGNED: To establish a predictive modeling for the risk of bloodstream infection associated with peripherally inserted central catheter (PICC).
UNASSIGNED: Patients receiving PICC treatment in Shenzhen People\'s Hospital from June 2020 to December 2020 were retrospectively enrolled and divided into the infection group and the non-infection group according to the presence and absence of PICC-related infections. Then, relevant clinical information of patients was collected and the predictors of PICC-related infection were screened by the least absolute shrinkage and selection operator regression (LASSO) model. Besides, multivariate logistic regression was used to analyze the influencing factors of PICC-related infection, A nomogram was constructed based on the results of the multivariate analysis. Ultimately, a receiver operating characteristic (ROC) curve was plotted to analyze the application value of influencing factors to predict PICC-related infections.
UNASSIGNED: A total of 505 patients were included, including 75 patients with PICC-related infections (14.85%). The main pathogen was gram-positive cocci. The predictors screened by LASSO included age >60 years, catheter movement, catheter maintenance cycle, insertion technique, immune function, complications, and body temperature ≥37.2 °C before PICC placement. Multivariate logistic regression analysis showed that independent risk factors of infections related to PICC included age >60 years [odds ratio (OR) = 1.722; 95% confidence interval (CI) = 1.312-3.579; P = 0.006], catheter movement (OR = 1.313; 95% CI = 1.119-3.240; P = 0.014), catheter maintenance cycle >7 days (OR = 2.199; 95% CI = 1.677-4.653; P = 0.000), direct insertion (OR = 1.036; 95% CI = 1.019-2.743; P = 0.000), poor immune function (OR = 2.322; 95% CI = 2.012-4.579; P = 0.000), complications (OR = 1.611; 95% CI = 1.133-3.454; P = 0.019), and body temperature ≥37.2 °C before PICC placement (OR = 1.713; 95% CI = 1.172-3.654; P = 0.012). Besides, the area under the ROC curve was 0.889.
UNASSIGNED: PICC-related infections are associated with factors such as age >60 years, catheter movement, catheter maintenance cycle, insertion technique, immune function, complications, and body temperature ≥37.2 °C before PICC placement. Additionally, the LASSO model is moderately predictive for predicting the occurrence of PICC-related infections.