病例组合指数与抗菌药物使用指标相关性分析OA

Objective To investigate the correlation and influencing factors between case mix index(CMI)and antibacterial drug use indicators.Methods Relevant data including CMI,antibacterial use density(AUD),number of discharged patients during the same period(N),cumulative defined daily doses(DDDs)of antibacterial drugs,and CMI×N of 49 clinical departments in the whole hospital in 2023 were retrospectively collected from the hospital information system(HIS).10 types of curve fitting(linear,logarithmic,reciprocal,quadratic,cubic,compound,power,S-curve,growth and exponential models)were performed to analyze the correlation.According to whether AUD was>40,the departments were divided into the high-intensity group(>40,n=20)and the low-intensity group(≤40,n=29),and the DDDs,CMI,N and CMI×N between the two groups were compared.With DDDs,N,CMI and CMI×N as test variables,the receiver operating characteristic curve(ROC curve)was used to evaluate the efficacy of predicting AUD>40,the area under the curve(AUC)of each test variable was calculated,and the cut-off value was obtained by calculating the Youden index for indicators with statistically significant differences(P<0.05).Results The cubic model fitting between CMI×N and DDDs was the optimal(R²=0.496,P<0.001),and the quadratic and cubic model fitting between CMI and AUD were the optimal(R²=0.412,P<0.001).There were no statistically significant differences in CMI,N and CMI×N between the two groups(P>0.05),while the DDDs in the high-intensity group was significantly higher than that in the low-intensity group(P<0.05).ROC curve analysis showed that the AUCs of DDDs,N,CMI and CMI×N for predicting AUD>40 were 0.793,0.369,0.654 and 0.486,respectively,among which,the predictive efficacy of DDDs was optimal,and the difference was statistically significant(P=0.001).According to the Youden index,the optimal cut-off value was determined to be 4 183.13.Conclusion There is a significant positive correlation between CMI×N and DDDs,as well as between CMI and AUD.The cut-off value of DDDs can be used as an early warning for high AUD risk.When DDDs>4 183.13,patients have a higher risk of AUD>40.