Logistic Regression Analysis the Risk Factors of Peripherally Inserted Central Catheter Related Blood Stream Infection of Tumor Patients

Objective: Our object is to study risk factors of tumor patients’ PICC catheter-related blood stream infection. Method: a retrospective analysis of data of 586 PICC catheterized patients was implemented, a univariate analysis of general data and catheterizing data of tumor patients was then carried out, and data of single factors with statistical significance were incorporated into multi-factor Logistic regression model for analysis. Results: PICC catheter-related blood stream infection occurred to 16 patients, and occurrence rate was 2.73%. Multi-factor Logistic regression analysis results showed that number of puncturing times, positioning method and maintenance frequency were risk factors for tumor patients’ peripherally inserted central catheter catheter-related blood stream infection, and odds risk values were respectively 8.762, 9.253 and 10.324. Conclusion: for tumor patients implanted with peripherally inserted central catheters, using ECG positioning during strict sterile operation and catheterizing process to avoid repeated puncturing and increasing maintenance frequency could effectively reduce occurrence of PICC catheter-related blood stream infection.

Analysis of risk factors for central venous port failure in cancer patients

AIM: To analyze the risk factors for central port failure in cancer patients administered chemotherapy, using univariate and multivariate analyses. METHODS: A total of 1348 totally implantable venous access devices (TIVADs) were implanted into 1280 cancer patients in this cohort study. A Cox proportional hazard model was applied to analyze risk factors for failure of TIVADs. Log-rank test was used to compare actuarial survival rates. Infection, thrombosis, and surgical complication rates (χ2 test or Fisher's exact test) were compared in relation to the risk factors. RESULTS: Increasing age, male gender and openended catheter use were signifi cant risk factors reducing survival of TIVADs as determined by univariate and multivariate analyses. Hematogenous malignancy decreased the survival time of TIVADs; this reduction was not statistically signifi cant by univariate analysis [hazard ratio (HR) = 1.336, 95% CI: 0.966-1.849, P = 0.080)]. However, it became a signifi cant risk factor by multivariate analysis (HR = 1.499, 95% CI: 1.079-2.083, P = 0.016) when correlated with variables of age, sex and catheter type. Close-ended (Groshong) catheters had a lower thrombosis rate than open-ended catheters (2.5% vs 5%, P = 0.015). Hematogenous malignancy had higher infection rates than solid malignancy (10.5% vs 2.5%, P < 0.001). CONCLUSION: Increasing age, male gender, openended catheters and hematogenous malignancy were risk factors for TIVAD failure. Close-ended catheters had lower thrombosis rates and hematogenous malignancy had higher infection rates.

Analysis of risk factors for epilepsy after stroke

Objective To explore the risk factors for epilepsy induced by stroke. Methods There were 179 patients with epilepsy caused by stroke,and 1 447 patients with cerebrovascular disorders without epilepsy after stroke. Multivariate noncondition stepwise logistic model analysis was made after single variable analysis.Results The following four factors were associated with epilepsy, i.e., large size of cerebral hemorrhage or cerebral infarction,subarachnoid hemorrhage, electrolyte disturbances and cortical lesions.Conclusion Epilepsy induced by stroke is mainly associated with the size of brain tissue necrosis.

Risk factor analysis of post-ERCP cholangitis: A single-center experience

Background: Endoscopic retrograde cholangiopancreatography(ERCP) may have complications. Our study aimed to investigate the risk factors and prevention of post-ERCP cholangitis.Methods: We retrospectively analyzed 4234 cases undergone ERCP in the Affiliated Drum Tower Hospital of Nanjing University Medical School from January 2008 to December 2013. Patient-related factors and procedure-related factors were analyzed to find the risk factors of post-ERCP cholangitis. The time point of post-ERCP cholangitis was also analyzed. Univariate and multivariate analyses were performed to define the independent risk factors of post-ERCP cholangitis.Results: The success rate of ERCP was 96.8%(4099/4234). The overall complication rate was 9.4%(399/4234). Post-ERCP cholangitis occurred in 102 cases(2.4%, 102/4234). The most dangerous time of post-ERCP cholangitis was from 24 h–48 h after ERCP(45.1%, 46/102). Univariate analysis revealed that age, hypertension, diabetes, previous ERCP history, biliary stent insertion, pancreatography, endoscopic sphincterotomy, balloon dilation and hilar obstruction were risk factors of post-ERCP cholangitis(P < 0.05). Multivariate analysis indicated that age, previous ERCP history and hilar obstruction were independent risk factors(P < 0.05). While endoscopic stone extraction was the potential protective factor.Conclusions: Many risk factors are involved in post-ERCP cholangitis. Among them, old age, previous ERCP history and hilar obstruction were independently related to this post-ERCP complication.

Risk factors and care of early surgical site infection after primary posterior lumbar interbody fusion

Objectives:To explore the risk factors and nursing measures of early surgical site infection(SSI)after posterior lumbar interbody fusion(PLIF).Methods:A total of 468 patients who received PLIF in our hospital from January 2017 to June 2020 were enrolled into this study.According to the occurrence of early SSI,the patients were divided into two groups,and the general data were analyzed by univariate analysis.Multivariate logistic regression analysis was conducted with the dichotomous variable of whether early SSI occurred and other factors as independent variables to identify the risk factors of early SSI and put forward targeted prevention and nursing measures.Results:Among 468 patients with PLIF,18 patients developed early SSI(3.85%).The proportion of female,age,diabetes mellitus and urinary tract infection(UTI),operation segment,operation time,post-operative drainage volume,and drainage time were significantly higher than those in the uninfected group,with statistical significance(P<0.05),whereas the preoperative albumin and hemoglobin in the infected group were significantly lower than those in the uninfected group,with statistical significance(P<0.05).There was no significant difference between the two groups in the American Society of Anesthesiologists(ASA)grading,body mass index(BMI),complications including cardiovascular and cerebrovascular diseases or hypertension(P>0.05).Logistic regression analysis showed that preoperative diabetes mellitus(OR=2.109,P=0.012)/UTI(OR=1.526,P=0.035),prolonged drainage time(OR=1.639,P=0.029)were risk factors for early SSI.Men(OR=0.736,P=0.027)and albumin level(OR=0.526,P=0.004)were protective factors in reducing early SSI.Conclusions:Women,preoperative diabetes/UTI,hypoproteinemia,and prolonged drainage time are risk factors for early SSI after PLIF.Clinical effective preventive measures should be taken in combination with targeted nursing intervention to reduce the risk of early SSI.

Risk factors of admission for acute colonic diverticulitis in a population-based cohort study: The North Trondelag Health Study, Norway

AIM To assess risk factors of hospital admission for acute colonic diverticulitis.METHODS The study was conducted as part of the second wave of the population-based North Trondelag Health Study(HUNT2), performed in North Trondelag County, Norway, 1995 to 1997. The study consisted of 42570 participants(65.1% from HUNT2) who were followed up from 1998 to 2012. Of these, 22436(52.7%) were females. The cases were defined as those 358 participants admitted with acute colonic diverticulitis during follow-up. The remaining participants were used as controls. Univariable and multivariable Cox regression analyses was used for each sex separately after multiple imputation to calculate HR.RESULTS Multivariable Cox regression analyses showed that increasing age increased the risk of admission for acute colonic diverticulitis: Comparing with ages < 50 years, females with age 50-70 years had HR = 3.42, P < 0.001 and age > 70 years, HR = 6.19, P < 0.001. In males the corresponding values were HR = 1.85, P = 0.004 and 2.56, P < 0.001. In patients with obesity(body mass index ≥ 30) the HR = 2.06, P < 0.001 in females and HR = 2.58, P < 0.001 in males. In females, present(HR = 2.11, P < 0.001) or previous(HR = 1.65, P = 0.007) cigarette smoking increased the risk of admission. In males, breathlessness(HR = 2.57, P < 0.001) and living in rural areas(HR = 1.74, P = 0.007) increased the risk. Level of education, physical activity, constipation and type of bread eaten showed no association with admission for acute colonic diverticulitis.CONCLUSION The risk of hospital admission for acute colonic diverticulitis increased with increasing age, in obese individuals, in ever cigarette smoking females and in males living in rural areas.

Holistic Evaluation of the Morbidity Due to Diabetes Mellitus Type 2 and Its Main Risk Factors in the State of San Luis Potosi, Mexico

Objective: To evaluate the morbidity due to diabetes mellitus type 2 within the State of San Luis Potosí, México, through a strong methodology, through which the multivariate relations were identified of the main social and environmental determiners in the disease, thus managing to quantify their respective levels of responsibility. Material and Methods: This evaluation began as a hypothesis of a multicasual theoretical model on diabetes mellitus and its main determining factors, which was analyzed through the application of multivariate exploratory statistical methodologies and confirmed as it is the case of the principal components analysis and the structural equation models. Results: Three components were extracted that explain the 96% of the total variance of the indicators;the main risk factors which were identified in the first component were, the use of the car, age, homes with TV use, urban life and feminine population;the indicators from the second and third component have little influence in the impact of the disease. Conclusions: the study shows the usefulness of the model for the analysis and prioritization of the environmental and social determiners of the disease, information that could sustain the design of public guidelines for the prevention and control of the analyzed disease.

Risk factors and prediction of macrosomia in a cohort study

Objective: To investigate the risk factors of macrosomia and to predict the risk of macrosomia so as to reduce the incidence of macrosomia. Methods: A total of 2063 pregnant women who met the inclusion criteria were selected as the subjects from February 2016 to April 2017 in Jiading District Maternal and Child Health Hospital of Shanghai and Pudong New Area Maternal and Child Health Hospital. According to the birth weight of the neonates, the neonates were divided into the macrosomia group (neonatal weight > 4000 g, n=125) and the normal infant group (2500 g < neonatal weight < 4000 g, n=1938).The general data of age, number of pregnant women, BMI before pregnancy, gestational diabetes mellitus, glucose tolerance, weight gain during pregnancy, birth weight and gestational week were compared between the two groups. Multivariate logistic regression was used to analyze the risk factors of macrosomia. Results: ①There were significant differences in BMI, glucose tolerance, fasting blood sugar, weight gain in the second trimester, weight gain in the third trimester, birth weight and gestational week between the two groups (P<0.05). ②Single factor analysis showed that pre-pregnancy BMI, gestational week at first diagnosis, fasting blood glucose tolerance, weight gain in the second trimester, weight gain in the third trimester, gestational week and birth weight were the influencing factors of macrosomia (P<0.05). ③Multi-factor analysis showed that gestational weeks, gestational diabetes, fasting glucose tolerance and weight growth in the second trimester were the main factors affecting the production of macrosomia, among which gestational diabetes was the protective factor, while gestational weeks, fasting glucose tolerance and weight growth in the second trimester were the risk factors. Conclusion: The high risk factors for macrosomia are gestational weeks, glucose tolerance, fasting blood sugar and weight gain in the second trimester of pregnancy.We should strengthen regular obstetric examination, health care during pregnancy, reasonable diet and proper exercise, and strictly control the weight gain during the second trimester of pregnancy. At the same time, we should monitor blood sugar in time so as to reduce the incidence of macrosomia.

Multivariate Analysis of Femoral Adductor Muscle Contracture after Total Hip Arthroplasty in Patients with Avascular Necrosis of Femoral Head

Objective:This study is to investigate the nisk factors of femoral head contracture after total hip arthroplasty(THA)in patients with avascular necrosis of femoral head.Methods:Retrospective analysis was perfomed in 361 cases of femoral head necrosis patients taking THA fom September 2016 to December 2017.A total of 179 patents with no significant preoperative adductor muscle contraction were finally enrolled in this study.These 179 patients were further divided into two groups:contracture group(64 cases)and noncompaction group(115 cases).The chi-square test was used to compare the differences between the two groups.Risk factors were identifed by logistic regession analysis.Results:of the patients included,64 patients (35.75%)developed into end adductor muscle contracture.There were signuificant differences in limb shortening.surgical history,whether taction,surgical approach,surgical methods,and fumctional training between the two goups(P<0.05).Logistic regression analysis showed that shortness of extremity,sugical approach,effective taction,surgical history,and etiology were the factors affecting femoral head contracture after THA in patients with avascular necrosis of femoral head.Conclusions:Preoperative traction therapy,surgical methods,and postoperative functional training are the factors that affect the adductor muscle contraction after THA.

影响结核性胸腔积液并发胸膜增厚的非条件Logistic回归分析

目的探讨影响结核性胸腔积液并发胸膜增厚的相关危险因素。方法回顾性分析2019年1月至2021年3月广州市胸科医院呼吸内科收治的123例结核性胸腔积液患者的临床资料,统计患者胸膜增厚情况,采用单因素及非条件Logistic回归法分析患者胸膜增厚的影响因素。结果胸膜未增厚与胸膜增厚患者性别、年龄、肺结核、胸水分布、用力肺活量(FVC)、第1秒用力呼气容积(FVE1)/FVC、胸水腺苷脱氨酶(ADA)、血清ADA、胸水白细胞、胸水淋巴细胞、胸水中性粒细胞和淋巴细胞比例比较差异无统计学意义;胸膜未增厚与胸膜增厚患者胸水量、胸水吸收时间、FVE1、胸水乳酸脱氢酶(LDH)、血清LDH、胸水蛋白、血清蛋白比较差异有统计学意义(P<0.05)。Logistic回归分析结果显示,胸水量(中大量)、FVE1、胸水LDH、血清LDH、胸水蛋白及血清蛋白是胸膜增厚发生的危险因素(P<0.05)。结论结核性胸腔积液并发胸膜增厚是多因素作用的结果,胸水量、FVE1、胸水吸收时间、胸水LDH、血清LDH、胸水蛋白和血清蛋白与胸膜增厚的发生密切相关,建议临床予以密切监测并积极采取针对性干预措施。

Risk factors for intussusception in children with Henoch-Schönlein purpura:A case-control study

BACKGROUND The etiology of Henoch-Schönlein purpura(HSP)with intussusception remains undefined.AIM To investigate the risk factors for intussusception in children with HSP and gastrointestinal(GI)involvement.METHODS Sixty children with HSP and concomitant intussusception admitted to the Beijing Children’s Hospital of Capital Medical University between January 2006 and December 2018 were enrolled in this study.One hundred pediatric patients with HSP and GI involvement but without intussusception,admitted to the same hospital during the same period,were randomly selected as a control group.The baseline clinical characteristics of all patients,including sex,age of onset,duration of disease,clinical manifestations,laboratory test results,and treatments provided,were assessed.Univariate and multiple logistic regression analyses were performed to identify possible risk factors.RESULTS The 60 children in the intussusception group comprised 27 girls(45%)and 33 boys(55%)and the 100 children in the non-intussusception group comprised 62 girls(62%)and 38 boys(38%).The median age of all patients were 6 years and 5 mo.Univariate and multiple regression analyses revealed age at onset,not receiving glucocorticoid therapy within 72 h of emergence of GI symptoms,hematochezia,and D-dimer levels as independent risk factors for intussusception in children with HSP(P<0.05).CONCLUSION The four independent risk factors for intussusception in pediatric HSP with GI involvement would be a reference for early prevention and treatment of this potentially fatal disease.

Investigation of contemporary college students’mental health status and construction of a risk prediction model

BACKGROUND Due to academic pressure,social relations,and the change of adapting to independent life,college students are under high levels of pressure.Therefore,it is very important to study the mental health problems of college students.Developing a predictive model that can detect early warning signals of college students’mental health risks can help support early intervention and improve overall well-being.AIM To investigate college students’present psychological well-being,identify the contributing factors to its decline,and construct a predictive nomogram model.METHODS We analyzed the psychological health status of 40874 university students in selected universities in Hubei Province,China from March 1 to 15,2022,using online questionnaires and random sampling.Factors influencing their mental health were also analyzed using the logistic regression approach,and R4.2.3 software was employed to develop a nomogram model for risk prediction.RESULTS We randomly selected 918 valid data and found that 11.3%of college students had psychological problems.The results of the general data survey showed that the mental health problems of doctoral students were more prominent than those of junior college students,and the mental health of students from rural areas was more likely to be abnormal than that of urban students.In addition,students who had experienced significant life events and divorced parents were more likely to have an abnormal status.The abnormal group exhibited significantly higher Patient Health Questionnaire-9(PHQ-9)and Generalized Anxiety Disorder-7 scores than the healthy group,with these differences being statistically significant(P<0.05).The nomogram prediction model drawn by multivariate analysis includ-ed six predictors:The place of origin,whether they were single children,whether there were significant life events,parents’marital status,regular exercise,intimate friends,and the PHQ-9 score.The training set demonstrated an area under the receiver operating characteristic(ROC)curve(AUC)of 0.972[95%confidence interval(CI):0.947-0.997],a specificity of 0.888 and a sensitivity of 0.972.Similarly,the validation set had a ROC AUC of 0.979(95%CI:0.955-1.000),with a specificity of 0.942 and a sensitivity of 0.939.The H-L deviation test result was χ^(2)=32.476,P=0.000007,suggesting that the model calibration was good.CONCLUSION In this study,nearly 11.3%of contemporary college students had psychological problems,the risk factors include students from rural areas,divorced parents,non-single children,infrequent exercise,and significant life events.

Environmental risk factors in children with cerebral palsy in Jiamusi,China

Most current studies focus on statistics of the incidence, etiology, and rehabilitative treatment of cerebral palsy. However, very few studies focus on the environmental risk factors for this syndrome In the present study, a total of 202 children with cerebral palsy in the Jiamusi district of China were selected as the case group, and 404 children were randomly selected for the control group. The survey focused on environmental factors during pregnancy, which included indoor pollution as the most dangerous factor （odds ratio = 2.432, 95% confidence interval = 1.172-5.047; P = 0.017）, followed by use of high-radiation mobile phones, more than 5 hours of watching television per day, and cooking with a marble kitchen platform during pregnancy. Results demonstrated that environmental risk factors play a role in the development of cerebral palsy in children.

基于logistic回归分析下颌第三磨牙近中、垂直阻生的危险因素

目的:探讨下颌第三磨牙近中、垂直阻生的危险因素,并基于logistic回归分析构建预测模型。方法:收集2021年6月—2023年12月天津市口腔医院243颗下颌第三磨牙的临床资料,根据萌出类型分为萌出组和阻生组,阻生组包括近中阻生和垂直单侧阻生。单因素分析筛选出具有统计学意义的因素后,采用logistic回归分析方法进行多因素分析,进一步绘制列线图,预测下颌第三磨牙阻生的风险因素。采用SPSS 27.0软件包对数据进行统计学分析。结果:243颗下颌第三磨牙中,萌出组75例(30.86%),阻生组168例(69.14%)。2组年龄、性别、牙根数、Co-Go、Co-Cop、W2、W3、W4和L相比,差异无统计学意义(P>0.05)。萌出组与阻生组Nolla、L-6缺失、L-E缺失、Co-Pog、Co-Go/Co-Pog、L6-MP、α和W1相比,差异有统计学意义(P<0.05)。多因素回归分析显示,Nolla、L-6缺失、L-E缺失、Co-Pog、Co-Go/Co-Pog、L6-MP、α和W1是下颌第三磨牙发生近中、垂直阻生的独立危险因素(P<0.05)。列线图构建显示较高的预测准确性。受试者工作特征曲线(ROC)分析结果表明,独立危险因素联合预测下颌第三磨牙近中、垂直阻生的曲线下面积(AUC)为0.924,95%CI为0.887~0.960,灵敏度为86.9%,特异度为86.7%。结论:Nolla、L-6缺失、L-E缺失、Co-Pog、Co-Go/Co-Pog、L6-MP、α和W1是影响下颌第三磨牙近中、垂直阻生的主要危险因素,利用logistic回归分析和列线图可有效预测阻生风险,为临床治疗提供科学依据。

基于Logistic回归分析建立慢性化脓性中耳炎合并听力损失的预测模型

目的:基于Logistic回归分析构建慢性化脓性中耳炎合并听力损失的预测模型。方法:选取2019年1月~2021年12月池州市第二人民医院收治的慢性化脓性中耳炎患者作为研究对象,依据听力损失发生情况分为听力损失组(n=117)和非听力损失组(n=102),使用单因素和多因素logistic回归分析慢性化脓性中耳炎合并听力损失的危险因素,并据此建立Logistic回归预测模型。结果:单因素分析显示,两组患者临床分类、慢性鼻窦炎、鼓室积脓和耳鸣障碍指数(THI)评分差异有统计学意义(P<0.05)。多因素Logistic回归分析显示,活动期、慢性鼻窦炎、鼓室积脓和THI评分高是慢性化脓性中耳炎合并听力损失的独立危险因素(P<0.05)。模型验证结果显示,C-index为0.782(95%CI:0.748~0.816),校准曲线趋近于理想曲线,ROC曲线下面积(AUC)为0.774(95%CI:0.743~0.805),在0%~66%内,模型净获益值>0。结论:活动期、慢性鼻窦炎、鼓室积脓和THI评分高会增加慢性化脓性中耳炎合并听力损失的风险,根据危险因素构建的Logistic回归模型能有效预测慢性化脓性中耳炎合并听力损失的风险。

基于logistic回归分析影响头颈部肿瘤患者睡眠的危险因素以及心理弹性变化轨迹

目的:探讨基于logistic回归分析影响头颈部肿瘤患者睡眠的危险因素以及心理弹性变化轨迹与睡眠之间的相关性。方法:回顾性分析2021年1月—2022年12月河南省肿瘤医院收治的850例头颈部肿瘤患者的临床资料。采用肿瘤心理弹性量表(RS-SC)和匹兹堡睡眠质量指数(PSQI)对患者的睡眠情况和心理弹性变化轨迹进行分析,并将PSQI得分>7分的患者纳入睡眠质量异常组(n=160),PSQI得分≤7分者纳入睡眠质量正常组(n=690)。分析影响头颈部肿瘤患者睡眠质量的风险因素。结果:放疗后,患者的RS-SC评分短暂升高,随着治疗时间的延长,RS-SC评分呈现逐渐降低的趋势,其PSQI得分整体呈先下降后上升的趋势。本研究纳入患者的睡眠质量异常率为18.82%;文化程度较低、放疗晚期、生理因素、环境因素、心理因素及频繁疼痛等因素均是影响头颈部肿瘤者睡眠质量异常的危险因素(OR=1.143、1.125、1.339、1.670、1.250、10.740,P<0.05)。结论:在头颈部肿瘤患者接受治疗期间患者心理弹性和睡眠质量均会发生明显改变,其中文化程度、放疗阶段、疼痛、心理、环境及生理因素均与其睡眠质量相关,应针以上风险因素为患者制定更为科学的干预方案。

创伤性骨折患者合并胸部损伤危险因素的Logistic回归分析

目的探讨创伤性骨折患者合并胸部损伤的危险因素。方法回顾性分析2019-01/2021-12月作者医院收治的3656例骨折住院患者的临床资料,根据是否合并胸部损伤分为胸部损伤组(n=623)和无胸部损伤组(n=3033)。比较骨折合并与不合并胸部损伤患者的年龄、性别、体质量指数(body mass index,BMI)、骨折部位、致伤原因等因素的差异,并通过多因素Logistic回归分析探讨骨折患者合并胸部损伤的独立影响因素。结果骨折合并与不合并胸部损伤患者在年龄、BMI和骨折季节方面比较差异均无统计学意义(P>0.05),而在性别、婚姻状况、文化程度、职业、居住地、骨折类型、骨折部位、骨折原因、骨折地点及基础疾病方面比较差异有统计学意义(P均<0.05)。多因素Logistic回归分析结果显示,小学以下文化程度、农民职业、肩部骨折和车祸伤、坠落伤是骨折患者合并胸部损伤的独立危险因素(P<0.05);而文化程度为初中/中专和大专以上,职业为工人、技术人员、办事人员,骨折部位为上肢、下肢,骨折原因为其他的骨折患者不易发生胸部损伤(P<0.05)。结论肩部骨折、车祸伤及坠落伤的骨折患者更容易合并胸部损伤,而文化程度越高、职业越是轻体力劳动者发生创伤性骨折合并胸部损伤的风险越低。

夏季建筑工地食堂食物中毒调查及危险因素的Logistic回归分析

目的:调查夏季营口市鲅鱼圈区2处建筑工地食堂食物中毒事件,查找该事件发生原因及致病因素,为制定防控措施提供科学依据。方法:按照国家有关食品安全标准与调查技术规范,对营口市鲅鱼圈区建筑工地食堂进行食物中毒筛查,对发生食物中毒工地的相关人员进行流行病学调查,并对病例、食堂留样食物开展相关病原菌分离培养,记录实验室检测信息。结果:2处建筑工地食堂就餐274人,共计209人发生食物中毒。食物中毒符合点源暴露模式,病例临床主要表现为恶心、头晕、呕吐;通过回顾性队列研究和Logistic回归分析发现,荤素包子与梅菜扣肉为食物中毒事件的可疑食品。结论:综合分析流行病学调查结果、现场卫生学调查及病例临床症状等,确定此次事件是因细菌引起的食物中毒事件,荤素包子与梅菜扣肉为最终致病食品。

系统性红斑狼疮并发股骨头坏死危险因素列线图预测模型的建立和验证

背景:股骨头坏死是系统性红斑狼疮患者常见的并发症,若能早期对其发生风险进行预测与验证,将有助于避免或延缓股骨头坏死的发展。目的:分析系统性红斑狼疮患者并发股骨头坏死的危险因素,构建系统性红斑狼疮患者并发股骨头坏死的列线图预测模型并进行验证。方法:回顾性分析2013年1月至2022年12月首次就诊于河南中医药大学第一附属医院的914例系统性红斑狼疮患者的病历资料,根据是否发生股骨头坏死分为发生股骨头坏死组(n=100)和未发生股骨头坏死组(n=814)。采用单因素、LASSO回归和多因素Logistic回归分析筛选和确定系统性红斑狼疮并发股骨头坏死的危险因素。同时将数据集按照7∶3的比例随机分为训练集和测试集,并基于多因素Logistic回归分析结果,构建系统性红斑狼疮并发股骨头坏死的列线图预测模型。同时,使用受试者工作特征曲线、Hosmer-Lemeshow校准曲线和决策曲线对列线图的性能进行评估。结果与结论:①股骨头坏死组与未发生股骨头坏死组患者在系统性红斑狼疮病程、系统性红斑狼疮疾病活动度评分、狼疮性肾炎、呼吸系统受累、胃肠道受累、干燥综合征、骨质疏松、抗核糖核蛋白抗体阳性、补体C3降低、环磷酰胺、吗替麦考酚酯、生物抑制剂、糖皮质激素最大日剂量、糖皮质激素冲击治疗方面差异有显著性意义(P<0.05);②采用LASSO回归分析方法筛选出10个与系统性红斑狼疮并发股骨头坏死风险相关的预测变量,将其纳入多因素Logistic回归分析,结果显示系统性红斑狼疮病程、呼吸系统受累、干燥综合征、骨质疏松、抗核糖核蛋白抗体阳性、环磷酰胺、吗替麦考酚酯、生物抑制剂、糖皮质激素最大日剂量是系统性红斑狼疮患者发生股骨头坏死的独立危险因素(P<0.05);③训练集中预测发生风险的受试者工作特征曲线下面积为0.802(95%CI=0.742-0.862),测试集预测发生股骨头坏死风险受试者工作特征曲线下面积为0.811(95%CI=0.745-0.876);Hosmer-Lemeshow校准曲线拟合度较好(训练集,P=0.447;验证集,P=0.870);决策曲线显示使用列线图预测模型预测系统性红斑狼疮患者发生股骨头坏死的风险是有益的;④月经异常为女性系统性红斑狼疮患者并发股骨头坏死的危险因素之一;⑤此次研究结果提示,系统性红斑狼疮并发股骨头坏死的危险因素是多因素的,同时建立了一个包含9个危险因素的列线图预测模型,可将其用于预测系统性红斑狼疮患者发生股骨头坏死的风险;此外,首次报道了月经异常为女性系统性红斑狼疮并发股骨头坏死的危险因素之一。

甘肃省女性尿失禁的流行病学调查及影响因素的多因素Logistic分析

目的:了解甘肃省女性尿失禁的流行状况,探讨相关影响因素。方法:对甘肃省东、西、中部地区部分城镇及农村20岁以上成年女性,采用分层、整群随机抽样的方法,抽取2700例进行女性尿失禁症状调查问卷,包括基本情况、尿失禁生活质量问卷、女性下尿路症状国际尿失禁标准问卷(ICIQ-FLUTS)现场调查。结果:获得有效问卷2603份。被调查对象年龄≥20岁,平均41.2±13.4岁。甘肃省女性尿失禁的平均患病率为41.3%(n=1074),其中压力性尿失禁、急迫性尿失禁、混合性尿失禁的患病率分别为19.9%(n=517)、2.7%(n=69)、18.6%(n=485),压力性尿失禁为最主要的一类。随着年龄的增长,混合性尿失禁患病率明显增加。多因素Logistic回归分析表明:体重指数、产次、饮酒、盆腔手术、便秘、慢性盆腔痛、盆腔脏器脱垂、会阴裂伤是尿失禁发生的危险因素。高文化水平、高经济收入、剖宫产、产后缩肛训练是其保护因素。结论:甘肃省成年女性尿失禁患病率较高,其中以压力性尿失禁为主。高体重指数、饮酒、便秘、慢性盆腔痛、盆腔脏器脱垂及多产、分娩时会阴裂伤等是尿失禁发生的危险因素,而提高文化水平、经济收入及产后进行缩肛训练等能一定程度预防和降低尿失禁的发生。