Journal of Shandong University (Health Sciences) ›› 2022, Vol. 60 ›› Issue (6): 90-96.doi: 10.6040/j.issn.1671-7554.0.2021.1425

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Establishment of a risk prediction scoring model for nosocomial infection in rheumatic heart disease patients after valve replacement surgery

YAO Xue1,2, LU Ranran1,2, SUN Shuling1,2, GAO Cuiping1,2, XIAO Ru1,2, WANG Shuhui2   

  1. 1. School of Nursing and Rehabilitation, Cheeloo College of Medicine, Shandong University, Jinan 250012, Shandong, China;
    2. Department of Infection Management, Qilu Hospital, Shandong University, Jinan 250012, Shandong, China
  • Published:2022-06-17

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Abstract: Objective To explore the risk factors of nosocomial infection in rheumatic heart disease(RHD)patients after valve replacement surgery and to establish a risk prediction scoring model. Methods The clinical data of RHD patients who underwent valve replacement surgery in a general hospital in Shandong Province during Jan. 2018 and Dec. 2019 were retrospectively analyzed. The independent risk factors of postoperative infection were analyzed with univariate and multivariate Logistic regression, and a risk prediction scoring model was constructed by assigning a score to each risk factor according to the odds ratio(OR). The predictive efficiency of the model was evaluated with receiver operating characteristic(ROC)curve. Results The nosocomial infection rate was 23.40%, and the primary pathogens of infection were Acinetobacter baumannii(13 cases)and Klebsiella pneumonia(5 cases). Stress hyperglycemia, postoperative Braden score <14, duration of pericardial mediastinal drainage ≥7 d, duration of endotracheal intubation ≥3 d, and glucocorticoid use ≥4 d were independent risk factors for nosocomial infection, and the score of each risk factor in the scoring model was 3, 3, 3, 5 and 3, respectively. Patients with total score ≥6 had high risk of infection. The validation results of the model: the area under the ROC curve was 0.853(95%CI: 0.805-0.902), and the sensitivity and specificity were 84.4% and 74.2%, respectively. Conclusion The incidence of infection in RHD patients undergoing valve replacement surgery is relatively high, and the scoring model can effectively predict risks of postoperative infection.

Key words: Rheumatic heart disease, Valve replacement surgery, Nosocomial infection, Risk factors, Scoring model

CLC Number: 

  • R619+.3
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