Establishment and validation of nomogram model for the risk of multidrug- resistant organism infection in patients after orthopedic trauma surgery
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1.Department of Infection Prevention and Control, Zhengzhou Central Hospital Affiliated to Zhengzhou University, Zhengzhou 450007, China;2.Department of Disease Control and Prevention, Zhengzhou Central Hospital Affiliated to Zhengzhou University, Zhengzhou 450007, China;3.Department of Laboratory Medicine, Zhengzhou Central Hospital Affiliated to Zhengzhou University, Zhengzhou 450007, China;4.Department of Orthopedics, Zhengzhou Central Hospital Affiliated to Zhengzhou University, Zhengzhou 450007, China

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    Abstract:

    Objective To explore the risk factors and establishment of risk nomogram model for multidrug-resistant organism (MDRO) infection in patients undergoing orthopedic trauma surgery. Methods Clinical data of 458 patients who undergoing orthopedic trauma surgery in an intensive care unit of a hospital from January 2019 to Ja-nuary 2021 were retrospectively analyzed, univariate and lasso logistic regression analysis were used to analyze independent risk factors for MDRO infection in hospitalized patients after orthopedic trauma surgery. The screened independent risk factors were included to establish nomogram prediction model, in addition, 224 orthopedic trauma patients from February to October 2021 were selected to establish a verification group to verify the data of modeling group. Results A total of 458 trauma patients were as the modeling group, including 114 trauma patients complicated with MDRO infection, with an infection rate of 24.89%; there were 344 patients in non-MDRO infection group. Clinical data of two groups of patients were conducted lasso logistic regression analysis, APACHE Ⅱ score≥20 points (OR=2.567, 95%CI: 1.593-4.178), fever days ≥ 3 days (OR=2.656, 95%CI: 1.631-4.361), hospitalization days≥10 days (OR=3.563, 95%CI: 2.207-5.808), antimicrobial use (OR=2.314, 95%CI: 1.415-3.848), combined antimicrobial use days ≥7 days (OR=2.114, 95%CI: 1.329-3.624) were independent risk factors for MDRO infection in patients after orthopedic trauma surgery. Based on the five independent risk factors in the regression analysis, a nomogram model for predicting MDRO infection after trauma surgery was established, the verification results showed that the predicted value was basically consistent with the measured value in the internal verification of Bootstrap, the area under the prediction curve (AUC) of modeling group and verification group were 0.877 8 and 0.871 8 respectively, which showed that the prediction model had good prediction ability. The decision curve analysis (DCA) showed that the model had high benefit. Conclusion The establishment of nomogram prediction model is conducive to early identification of the high-risk factors of post-operative MDRO infection in trauma surgery patients, and timely take prevention and control measures, so as to reduce MDRO healthcare-associated infection.

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郭磊磊,秦红英,张尚书,等.骨科创伤患者术后多重耐药菌感染风险Nomogram模型构建与验证[J].中国感染控制杂志英文版,2022,(6):584-591. DOI:10.12138/j. issn.1671-9638.20222616.
Lei-lei GUO, Hong-ying QIN, Shang-shu ZHANG, et al. Establishment and validation of nomogram model for the risk of multidrug- resistant organism infection in patients after orthopedic trauma surgery[J]. Chin J Infect Control, 2022,(6):584-591. DOI:10.12138/j. issn.1671-9638.20222616.

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  • Received:March 09,2022
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  • Online: April 28,2024
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