颅脑创伤术后继发肺部感染的危险因素分析及相关模型构建

目的分析颅脑创伤术后继发肺部感染的危险因素,并构建风险预测模型。方法回顾性分析2018年1月至2019年12月在我院进行颅脑创伤术的272例患者临床资料,根据术后是否发生肺部感染分为肺部感染组(89例)与非肺部感染组(183例),收集两组患者临床资料进行单因素与多因素Logistic回归分析,探究颅脑创伤术后继发肺部感染的危险因素,并构建风险预测模型。结果单因素分析结果显示:GCS评分、手术次数>2次、合并肺部基础疾病、术后白蛋白水平、昏迷时间、进行机械通气、吸烟等因素与继发肺部感染有关(均P<0.05)。Logistic回归分析结果显示:GSC评分低、合并肺部疾病、昏迷时间长以及需要机械通气是颅脑创伤患者术后继发肺部感染的独立危险因素。构建模型经ROC曲线分析得出AUC为0.864,经过验证得出模型预测特异性为88.89%,灵敏性为81.82%,准确性为86.46%。结论GSC评分低、合并肺部疾病、昏迷时间长以及需要机械通气的颅脑创伤患者,术后发生肺部感染的风险更高,临床上要对此类患者予以重点关注。根据危险因素建立预测模型,预测对指导临床上颅脑创伤患者术后降低肺部感染发生率具有一定作用。

Analysis of risk factors for secondary lung infection after craniocerebral trauma and construction of related models

Objective To analyze the risk factors of secondary lung infection after craniocerebral trauma and build a risk prediction model.Methods The clinical data of 272 patients undergoing craniocerebral trauma in our hospital from January 2018 to December 2019 were retrospectively analyzed.According to whether postoperative lung infection occurred,it was divided into the lung infection group(89 cases)and the non-pulmonary infection group(183 cases).The clinical data were collected for univariate and multivariate logistic regression analysis,the risk factors of secondary lung infection after craniocerebral trauma were explored,and a risk prediction model was built.Results The results of single factor analysis showed that:GCS score,the number of operations>2 times,combined with underlying lung disease,postoperative albumin level,coma time,mechanical ventilation,smoking and other factors were related to secondary lung infection(all P<0.05).Logistic regression analysis showed that low GSC score,combined pulmonary disease,long coma,and the need for mechanical ventilation were independent risk factors for postoperative pulmonary infection in patients with craniocerebral trauma.The ROC curve analysis of the constructed model shows that the AUC was 0.864.After verification,the model predicted that the specificity was 88.89%,the sensitivity was 81.82%,and the accuracy was 86.46%.Conclusion Patients with low GSC scores,pulmonary disease,long coma,and craniocerebral trauma requiring mechanical ventilation have a higher risk of pulmonary infection after surgery.Clinically,such patients should be paid more attention to establishing prediction models based on risk factors,which has a certain role in guiding clinical patients with craniocerebral trauma to reduce the incidence of lung infection after surgery.