脑卒中病人导管相关性尿路感染风险预测模型的构建和评价OA

Objective:To explore the risk factors of catheter-associated urinary tract infection(CAUTI)in stroke patients,construct a risk prediction model,and evaluate its application effect.Methods:A total of 350 stroke patients admitted to the hospital from November 2021 to November 2023 were selected as the modeling group.The clinical data of all patients were retrospectively analyzed.Among them,70 patients with CAUTI were included in the infection group,and 280 patients without CAUTI were included in the non-infection group.Univariate and Logistic regression analyses were used to identify the risk factors for CAUTI in stroke patients,and a risk prediction model was constructed.The predictive efficacy of the model was evaluated using the receiver operating characteristic(ROC)curve.Another 95 stroke patients admitted to the hospital from December 2023 to December 2024 were selected as the validation group to evaluate the application effect.Result:Among 350 stroke patients,70 cases developed CAUTI,accounting for 20.00%(70/350).The results of the univariate analysis showed that there were statistically significant differences in gender,age,length of hospital stay,duration of urinary catheter placement,number of catheter insertions,D-dimer level,history of diabetes,and status of consciousness between the infection group and the non-infection group(P<0.05).The results of the Logistic regression analysis indicated that being female,age>75 years old,length of hospital stay≥10 days,duration of urinary catheter placement>7 days,number of catheter insertions>3 times,D-dimer>0.5 mg/L,having a history of diabetes,and having a state of consciousness disorder were risk factors for CAUTI in stroke patients(P<0.05).A risk prediction model was constructed,with the area under the ROC curve(AUC)being 0.858[95%CI(0.875,0.962)],the maximum Youden index being 0.705,the sensitivity being 0.842,and the specificity being 0.865.Conclusions:Being female,advanced age,long hospital stay,long duration of urinary catheter placement,multiple catheter insertions,elevated D-dimer level,history of diabetes,and state of consciousness disorder are all risk factors for CAUTI in stroke patients.Clinically,it is necessary to reasonably assess the high-risk factors of CAUTI,achieve early identification and prevention,and actively take effective nursing measures to reduce the incidence of CAUTI in stroke patients after urinary catheter placement.