精神分裂症患者医院感染危险因素及其预测模型构建

Risk factors for nosocomial infection in patients with schizophrenia and establishment of prediction model

目的分析精神分裂症患者医院感染危险因素并构建其预测模型.方法回顾性收集2019年10月-2022年12月在景德镇市第四人民医院住院的40例医院感染的精神分裂症患者为感染组,随机选取同期住院的95例未发生医院感染的精神分裂症患者为未感染组,分析精神分裂症患者医院感染危险因素,并构建相关回归方程,采用受试者工作特征(ROC)曲线分析回归方程对精神分裂症患者医院感染的预测价值.结果多因素Logistic回归分析结果显示,合并糖尿病、管理方式为封闭式管理、有电休克治疗、使用抗精神病药物种类>2种均为精神分裂症患者医院感染的危险因素(P<0.05).回归方程:logit(P)=-11.208+合并糖尿病情况×1.352+管理方式×1.426+电休克治疗情况×1.382+使用抗精神病药物种类×1.052.ROC曲线结果显示,回归方程预测精神分裂症患者医院感染的曲线下面积(AUC)为0.792、敏感度为82.50%、特异度为68.42%.结论精神分裂症患者医院感染危险因素包括合并糖尿病、管理方式为封闭式管理、有电休克治疗、使用抗精神病药物种类>2种,临床可采用相关回归方程对精神分裂症患者医院感染发生的风险进行预测,并及时采取相关预防措施,降低患者医院感染发生风险.

OBJECTIVE To analyze the risk factors for nosocomial infection in the patients with schizophrenia and establish the prediction model.METHODS A total of 40O schizophrenia patients with nosocomial infection who were hospitalized in the Fourth People's Hospital of Jingdezhen from Oct 2019 to Dec 2022 were retrospectively collected an assigned as the infection group,meanwhile,95 schizophrenia patients who did not have nosocomial infection were chosen as the no infection group.The risk factors for the nosocomial infection were analyzed,the related regression equation was established,and the value of the regression equation in prediction of the nosocomial infection was analyzed by means of ROC curve.RESULTS The result of multivariate logistic regression analysis showed that complication with diabetes mellitus,closed-off management,electroconvulsive therapy and use of more than 2 types of antipsychotics were the risk factors for the nosocomial infection in the patients with schizophrenia(P<0.05).The regression equation was as follows:logit(P)=-11.208+complication with diabetes mellitus X 1.352+management style X 1.426+e;electroconvulsive therapy X 1.382+type of antipsychotics X 1.052.ROC curve analysis indicated that the area under curve(AUC)of the regression equation was O.792 in prediction of nosocomial infection in the patients with schizophrenia,with the sensitivity 82.50%,the specificity 68.42%.CONCLUSION The risk factors for the nosocomial infection in the patients with schizophrenia include the complication with diabetes mellitus,closed-off management,electroconvulsive therapy and use of more than 2 types of antipsychotics.The regression equation can be used for prediction of the risk for nosocomial infection in the patients with schizophrenia,and it is necessary for the hospital to take related prevention measures so as to reduce the risk of nosocomial infection.