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预测医疗保健相关性感染:患病率时点调查数据是否有用?

Predicting Healthcare-associated Infections: are Point of Prevalence Surveys data useful?

机构信息

Post Graduate School of Public Health, University of Siena, Italy.

Department of Medical Biotechnologies, University of Siena, Italy.

出版信息

J Prev Med Hyg. 2022 Jul 31;63(2):E304-E309. doi: 10.15167/2421-4248/jpmh2022.63.2.1496. eCollection 2022 Jun.

Abstract

INTRODUCTION

Since 2012, the European Centre for Disease Prevention and Control (ECDC) promotes a point prevalence survey (PPS) of HAIs in European acute care hospitals. Through a retrospective analysis of 2012, 2015 and 2017 PPS of HAIs performed in a tertiary academic hospital in Italy, we developed a model to predict the risk of HAI.

METHODS

Following ECDC protocol we surveyed 1382 patients across three years. Bivariate logistic regression analyses were conducted to assess the relationship between HAI and several variables. Those statistically significant were included in a stepwise multiple regression model. The goodness of fit of the latter model was assessed with the Hosmer-Lemeshow test, ultimately constructing a probability curve to estimate the risk of developing HAIs.

RESULTS

Three variables resulted statistically significant in the stepwise logistic regression model: length of stay (OR 1.03; 95% CI: 1.02-1.05), devices breaking the skin (i.e. peripheral or central vascular catheter, OR 4.38; 95% CI: 1.52-12.63), urinary catheter (OR 4.71; 95% CI: 2.78-7.98).

CONCLUSION

PPSs are a convenient and reliable source of data to develop HAIs prediction models. The differences found between our results and previously published studies suggest the need of developing hospital-specific databases and predictive models for HAIs.

摘要

简介

自 2012 年以来,欧洲疾病预防控制中心(ECDC)一直在推动欧洲急性护理医院中医院获得性感染(HAI)的患病率调查(PPS)。通过对意大利一家三级学术医院 2012 年、2015 年和 2017 年 HAI 患病率调查的回顾性分析,我们开发了一种预测 HAI 风险的模型。

方法

我们按照 ECDC 方案在三年间调查了 1382 名患者。采用二项逻辑回归分析评估 HAI 与多个变量之间的关系。那些统计学上显著的变量被纳入逐步多元回归模型。后者模型的拟合优度用 Hosmer-Lemeshow 检验进行评估,最终构建了一条概率曲线来估计发生 HAI 的风险。

结果

逐步逻辑回归模型中三个变量具有统计学意义:住院时间(OR 1.03;95%CI:1.02-1.05)、皮肤穿透性器械(即外周或中心血管导管,OR 4.38;95%CI:1.52-12.63)、导尿管(OR 4.71;95%CI:2.78-7.98)。

结论

PPS 是开发 HAI 预测模型的便捷可靠的数据来源。我们的研究结果与之前发表的研究之间的差异表明,有必要为 HAI 开发特定于医院的数据库和预测模型。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8f7d/9351422/58936b5191ce/jpmh-2022-02-e304-e001.jpg

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