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神经源性膀胱患者尿路感染风险预测模型。

A risk prediction model of urinary tract infections for patients with neurogenic bladder.

机构信息

Shenzhen Hospital, Southern Medical University, Shenzhen, China.

School of Nursing, Southern Medical University, Guangzhou, China.

出版信息

Int J Neurosci. 2021 Jan;131(1):31-39. doi: 10.1080/00207454.2020.1732973. Epub 2020 Feb 27.

DOI:10.1080/00207454.2020.1732973
PMID:32075472
Abstract

To develop a nomogram to evaluate the risk of urinary tract infections (UTI) in patients with neurogenic bladder (NGB) A retrospective analysis was conducted on 337 patients with NGB admitted to three hospitals. Collected data included clinical symptoms, patients' general characteristics, laboratory examinations and imaging findings. Multivariate logistic regression analysis was conducted to develop the risk prediction nomogram of UTIs for NGB patients. C index was used for the internal and external validation of that model. The occurrence of UTIs was 45.7% (154 of 337), 52.6% (102 of 194), and 36.4% (52 of 143) in the overall, training and validation data sets, respectively. The prediction nomogram was developed with 5 prognostic factors which included white blood cell (WBC) in blood, Leukocyte (LEU) in urine, Urinary pH, length of stay and urination mode. The nomogram presented good discrimination with a C-index value of 0.921 (95% confidence interval: 0.87396 - 0.96804) and good calibration. The C-index values of the interval validation and external validation were 0.8905541 and 0.817, respectively. The results of decision curve analysis (DCA) demonstrated that the model was clinically useful. The prediction nomogram we developed is a simple and accurate tool for early prediction of UTIs in patients with NGB. This tool can assess risk of UTIs early, allowing for timely initiation of appropriate preventive measures.

摘要

为了开发一种列线图来评估神经源性膀胱(NGB)患者发生尿路感染(UTI)的风险,我们对三家医院收治的 337 例 NGB 患者进行了回顾性分析。收集的数据包括临床症状、患者一般特征、实验室检查和影像学发现。采用多变量逻辑回归分析来建立 NGB 患者 UTI 风险预测列线图。采用 C 指数对内、外部模型进行验证。337 例患者中,UTI 的总发生率为 45.7%(154/337),训练集和验证集分别为 52.6%(102/194)和 36.4%(52/143)。该预测列线图由 5 个预后因素组成,包括血液中的白细胞(WBC)、尿液中的白细胞(LEU)、尿 pH 值、住院时间和排尿方式。该列线图具有良好的判别能力,C 指数为 0.921(95%置信区间:0.87396–0.96804),校准度良好。区间验证和外部验证的 C 指数值分别为 0.8905541 和 0.817。决策曲线分析(DCA)的结果表明该模型具有临床实用性。我们开发的预测列线图是一种简单、准确的工具,可用于早期预测 NGB 患者的 UTI。该工具可以早期评估 UTI 的风险,从而及时采取适当的预防措施。

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