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开发和验证 ICU 患者口腔黏膜压力性损伤的列线图:一项前瞻性队列研究。

Development and validation of a nomogram for oral mucosal membrane pressure injuries in ICU patients: A prospective cohort study.

机构信息

Department of Critical Care Medicine, West China Hospital, Sichuan University/West China School of Nursing, Sichuan University, Chengdu, China.

Department of Critical Care Medicine, People's Hospital of Zhongjiang County, Zhongjiang, Sichuan Province, China.

出版信息

J Clin Nurs. 2024 Oct;33(10):4112-4123. doi: 10.1111/jocn.17296. Epub 2024 May 26.

Abstract

AIMS

Establishing a nomogram to estimate the probability of oral mucosal membrane pressure injury of endotracheal tube-intubated hospitalized patients in intensive care unit.

DESIGN

Multicentre prospective cohort study.

METHODS

Using Lasso regression and COX regression, variable selection was performed on demographic, clinical and laboratory data of 1037 ICU endotracheal tube-intubated hospitalized patients from West China Hospital, to construct a nomogram. External validation was conducted on 484 ICU endotracheal tube-intubated patients from People's Hospital of Zhongjiang County.

RESULTS

Among 38 potential predictors, five variables emerged as independent predictors, integrated into the nomogram: administration of antibiotics, nutritional therapy duration, agitation, hypotension and albumin levels.

CONCLUSIONS

We established a nomogram based on the hospital characteristics of ICU endotracheal tube-intubated patients, aiding in the prediction of the occurrence of oral mucosal membrane pressure injury.

REPORTING METHOD

The study followed TRIPOD guidelines.

RELEVANCE TO CLINICAL PRACTICE

The nomogram we developed can assist clinical worker in better identifying at-risk patients and risk factors. It enables the implementation of evidence-based nursing interventions in care to prevent the development of oral mucosal membrane pressure injury.

TRIAL REGISTRATION

The study has been registered with the Chinese Clinical Trial Registry (http://www.chictr.org.cn) under registration number ChiCTR2200056615.

摘要

目的

建立一个列线图,以估计 ICU 住院患者经气管插管后的口腔黏膜膜压力损伤的概率。

设计

多中心前瞻性队列研究。

方法

使用 Lasso 回归和 COX 回归,对来自华西医院的 1037 例 ICU 气管插管住院患者的人口统计学、临床和实验室数据进行变量选择,以构建列线图。对中江县人民医院的 484 例 ICU 气管插管住院患者进行外部验证。

结果

在 38 个潜在预测因子中,有 5 个变量被确定为独立预测因子,纳入到列线图中:抗生素的使用、营养治疗的持续时间、躁动、低血压和白蛋白水平。

结论

我们基于 ICU 气管插管住院患者的医院特征建立了一个列线图,以帮助预测口腔黏膜膜压力损伤的发生。

报告方法

本研究遵循 TRIPOD 指南。

与临床实践的相关性

我们开发的列线图可以帮助临床工作人员更好地识别高危患者和风险因素。它使临床工作者能够实施基于证据的护理干预措施,以预防口腔黏膜膜压力损伤的发生。

试验注册

该研究已在中国临床试验注册中心(http://www.chictr.org.cn)注册,注册号为 ChiCTR2200056615。

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