Department of Pediatric Urology, Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China.
Department of Nursing, Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China.
Front Public Health. 2022 Jun 22;10:888089. doi: 10.3389/fpubh.2022.888089. eCollection 2022.
Urinary tract infection (UTI) is a common complication in pediatric urological surgery patients and is associated with long-term sequelae, including subsequent recurrent infections and renal scarring. In this study, we aimed to explore the risk factors for UTI in pediatric urological surgery patients and construct a predictive model for UTI.
A total of 2,235 pediatric patients who underwent urological surgery at a tertiary hospital between February 2019 and January 2020 were included. A multivariate logistic regression model was applied to identify the predictive factors, and a predictive model was constructed using a receiver operating characteristic curve. A multifactorial predictive model was used to categorize the risk of UTI based on the weight of the evidence.
A total of 341 patients with UTI were identified, which corresponded to a prevalence of 15.26% in pediatric urological surgery patients. Multivariate analysis identified six significant risk factors for UTI, including age <12.0 months, upper urinary tract disease, not using an indwelling drainage tube, hospital stay ≥10 days, administration of two or more types of antibiotics, and stent implantation. A combination of the aforementioned factors produced an area under the curve value of 88.37% for preventing UTI in pediatric urological surgery patients. A multifactorial predictive model was created based on the combination of these factors.
The constructed multifactorial model could predict UTI risk in pediatric urological surgery patients with a relatively high predictive value.
尿路感染(UTI)是小儿泌尿外科手术患者常见的并发症,与长期后遗症有关,包括随后的反复感染和肾瘢痕形成。本研究旨在探讨小儿泌尿外科手术患者 UTI 的危险因素,并构建 UTI 的预测模型。
共纳入 2019 年 2 月至 2020 年 1 月在一家三级医院接受泌尿外科手术的 2235 例小儿患者。采用多变量逻辑回归模型确定预测因素,并通过受试者工作特征曲线构建预测模型。采用多因素预测模型根据证据权重对 UTI 风险进行分类。
共发现 341 例 UTI 患者,占小儿泌尿外科手术患者的 15.26%。多因素分析确定了 UTI 的 6 个显著危险因素,包括<12.0 个月的年龄、上尿路疾病、未使用留置引流管、住院时间≥10 天、使用两种或两种以上类型的抗生素和支架植入。上述因素的组合对预防小儿泌尿外科手术患者 UTI 的曲线下面积值为 88.37%。基于这些因素的组合建立了多因素预测模型。
构建的多因素模型可以预测小儿泌尿外科手术患者 UTI 的风险,具有较高的预测价值。