本文選題：醫(yī)院獲得性肺炎　切入點(diǎn)：logistic回歸分析　出處：《中華醫(yī)院感染學(xué)雜志》2015年11期 　論文類型：期刊論文

【摘要】：目的通過單因素和多因素分析篩選出與醫(yī)院獲得性肺炎(hospital-acquired pneumonia,HAP)發(fā)生相關(guān)的危險(xiǎn)因素,構(gòu)建風(fēng)險(xiǎn)預(yù)測模型。方法回顧性收集2009年1月-2013年12月醫(yī)院ICU 539例住院患者臨床資料(A組),采用logistic回歸分析篩選危險(xiǎn)因素、建立風(fēng)險(xiǎn)預(yù)測模型,另外前瞻性收集2014年1-6月ICU 88例住院患者資料(B組),以驗(yàn)證該模型的臨床預(yù)測價(jià)值。結(jié)果 A組539例患者中發(fā)生HAP215例,單因素分析結(jié)果顯示,患者年齡、APACHEⅡ評分、患心血管系統(tǒng)疾病及多器官功能障礙綜合征(MODS)、心肺復(fù)蘇術(shù)、感染性休克、惡性腫瘤、合并肺外感染、低蛋白血癥、C-反應(yīng)蛋白(CRP)值及降鈣素原(PCT)值高、機(jī)械通氣、無創(chuàng)通氣、輸血、預(yù)防性使用抑酸藥物等在HAP發(fā)生與否的差異有統(tǒng)計(jì)學(xué)意義;多因素logistic回歸分析結(jié)果顯示,APACHEⅡ評分、MODS、低蛋白血癥、PCT值高、無創(chuàng)通氣、輸血是HAP發(fā)生的獨(dú)立危險(xiǎn)因素;利用B組數(shù)據(jù)驗(yàn)證該公式預(yù)測HAP靈敏性為85.2%、特異性為75.6%,陽性預(yù)測值為80.38%,陰性預(yù)測值為83.75%。結(jié)論多因素logistic回歸模型能夠較好地預(yù)測危重患者HAP發(fā)生的風(fēng)險(xiǎn)。
[Abstract]:Objective to screen the risk factors associated with hospital acquired pneumonia (HAP) by univariate and multivariate analysis. Methods the clinical data of 539 inpatients with ICU from January 2009 to December 2013 were collected retrospectively. The risk factors were screened by logistic regression analysis, and the risk prediction model was established. In addition, 88 inpatients with ICU from 2014 to June were prospectively collected to verify the clinical predictive value of the model. Results in group A, HAP215 occurred in 539 patients. Univariate analysis showed that the age of the patients was evaluated with Apache 鈪，

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