手术部位感染风险预警模型构建

Establishment of risk warning model for surgical site infection

摘要:

目的构建手术部位感染风险预警模型，为筛查高危人群、发现疑似感染病例提供帮助。 方法回顾性收集2013年1月—2015年12月国内6所医院5 067例腹部外科手术患者病例资料，将所有病例按照6︰4的比例随机分为建模组和验证组，采用logistic回归建立预警模型，以ROC曲线下面积(AUC)评价模型的判别能力，以约登指数最大作为最佳截断点。结果高危患者预警模型AUC为0.823，灵敏度为78.81%，特异度为74.33%，阳性预测值为19.67%，阴性预测值为97.78%。疑似感染病例判别模型AUC为0.978，灵敏度93.38%，特异度95.62%，阳性预测值62.95%，阴性预测值为99.45%。结论此研究建立的预警模型判别能力较好，可以为医院感染信息系统的预警和判别开发提供参考。

Abstract:

ObjectiveTo establish a risk warning model for surgical site infection（SSI）, provide support for screening high risk population and finding suspected cases. MethodsClinical data of 5 067 patients who underwent abdominal surgery in 6 domestic hospitals from January 2013 to December 2015 were collected retrospectively, all cases were randomly divided into modeling group and validation group according to a 6:4 ratio,  warning model was established by employing logistic regression, the area under the receiver operating characteristic curve (AUC) was used to evaluate discriminant ability of evaluation model, the maximum Youden index was as the optimum cutoff point. ResultsFor the warning model of highrisk patients, AUC was 0.823, sensitivity and specificity were 78.81% and 74.33% respectively, positive predictive value and negative predictive value were 19.67% and 97.78% respectively. For the discriminant model of suspected infection cases, AUC was 0.978, sensitivity and specificity were 93.38% and 95.62% respectively, positive predictive value and negative predictive value were 62.95% and 99.45% respectively.ConclusionThe earlywarning model established in this study has better discrimination ability, which can provide a reference for the development of early warning and discrimination of healthcareassociated infection information system.