長期臥床老年病人并發(fā)肺炎的危險因素及Nomogram預測模型構(gòu)建

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Risk factors and Nomogram prediction model construction for complications of pneumonia in long?term bedridden elderly patients

LIU Xia， GUO Siyu， ZHANG Ziwei

Beijing Friendship Hospital， Capital Medical University， Beijing 100050 China

Corresponding Author  LIU Xia， E?mail： [email protected]

Abstract  Objective：To analyze the risk factors for complications of pneumonia in long?term bedridden elderly patients and construct their Nomogram prediction model to provide a basis for clinical formulation of prevention and treatment strategies.Methods：One hundred and seventy?six long?term bedridden patients admitted to our geriatric department from January 2018 to January 2022 were selected and divided into 82 cases in the pneumonia group and 94 cases in the no pneumonia group according to whether they were complicated by pneumonia.The demographic data and clinical characteristics of the two groups were compared.Logistic regression equation was used to analyze the influencing factors related to the complication of pneumonia in long?term bedridden patients in the geriatric department，and a Nomogram prediction model was constructed.The predictive efficacy of the model was evaluated using the subject operating characteristic curve（ROC） and the area under the ROC（AUC），and the clinical benefit of the model was evaluated using the decision curve analysis（DCA）.Results：Bedridden time，painful cough，poor oral cleanliness，impaired consciousness，impaired swallowing，invasive mechanical ventilation，and malnutrition were risk factors associated with complications of pneumonia in elderly patients who were bedridden for a long time（P<0.05）；the predictive risk capacity index（C?index） of the Nomogram prediction model was 0.931 with an AUC of 0.931；the DCA curve showed that the model had a positive net benefit.Conclusion：Time spent in bed，cough pain，poor oral cleanliness，impaired consciousness，dysphagia，invasive mechanical ventilation，and malnutrition are risk factors for pneumonia in long?term bedridden elderly patients.

Keywords  the elderly； pneumonia； long?term bed rest； risk factors； Nomogram model； predictive efficacy

摘要  目的：分析長期臥床老年病人并發(fā)肺炎的危險因素，并構(gòu)建其Nomogram預測模型，為臨床制定防治策略提供依據(jù)。（剩余10828字）