Liu Xiao-Chen, Chang Xiao-Jie, Zhao Si-Ren, Zhu Shan-Shan, Tian Yan-Yan, Zhang Jing, Li Xin-Yue
Department of Neurosurgery, Shandong Provincial Third Hospital, Jinan 250031, Shandong Province, China.
Department of Neurology, Shandong Provincial Third Hospital, Jinan 250031, Shandong Province, China.
World J Clin Cases. 2024 Jul 16;12(20):4048-4056. doi: 10.12998/wjcc.v12.i20.4048.
Post-stroke infection is the most common complication of stroke and poses a huge threat to patients. In addition to prolonging the hospitalization time and increasing the medical burden, post-stroke infection also significantly increases the risk of disease and death. Clarifying the risk factors for post-stroke infection in patients with acute ischemic stroke (AIS) is of great significance. It can guide clinical practice to perform corresponding prevention and control work early, minimizing the risk of stroke-related infections and ensuring favorable disease outcomes.
To explore the risk factors for post-stroke infection in patients with AIS and to construct a nomogram predictive model.
The clinical data of 206 patients with AIS admitted to our hospital between April 2020 and April 2023 were retrospectively collected. Baseline data and post-stroke infection status of all study subjects were assessed, and the risk factors for post-stroke infection in patients with AIS were analyzed.
Totally, 48 patients with AIS developed stroke, with an infection rate of 23.3%. Age, diabetes, disturbance of consciousness, high National Institutes of Health Stroke Scale (NIHSS) score at admission, invasive operation, and chronic obstructive pulmonary disease (COPD) were risk factors for post-stroke infection in patients with AIS ( < 0.05). A nomogram prediction model was constructed with a C-index of 0.891, reflecting the good potential clinical efficacy of the nomogram prediction model. The calibration curve also showed good consistency between the actual observations and nomogram predictions. The area under the receiver operating characteristic curve was 0.891 (95% confidence interval: 0.839-0.942), showing predictive value for post-stroke infection. When the optimal cutoff value was selected, the sensitivity and specificity were 87.5% and 79.7%, respectively.
Age, diabetes, disturbance of consciousness, NIHSS score at admission, invasive surgery, and COPD are risk factors for post-stroke infection following AIS. The nomogram prediction model established based on these factors exhibits high discrimination and accuracy.
卒中后感染是卒中最常见的并发症,对患者构成巨大威胁。卒中后感染除延长住院时间和增加医疗负担外,还显著增加疾病和死亡风险。明确急性缺血性卒中(AIS)患者卒中后感染的危险因素具有重要意义。它可指导临床实践尽早开展相应的防控工作,将卒中相关感染风险降至最低,确保良好的疾病转归。
探讨AIS患者卒中后感染的危险因素并构建列线图预测模型。
回顾性收集2020年4月至2023年4月我院收治的206例AIS患者的临床资料。评估所有研究对象的基线数据和卒中后感染状况,分析AIS患者卒中后感染的危险因素。
共有48例AIS患者发生卒中后感染,感染率为23.3%。年龄、糖尿病、意识障碍、入院时美国国立卫生研究院卒中量表(NIHSS)评分高、侵入性操作及慢性阻塞性肺疾病(COPD)是AIS患者卒中后感染的危险因素(<0.05)。构建的列线图预测模型C指数为0.891,反映出列线图预测模型具有良好的潜在临床效能。校准曲线也显示实际观察值与列线图预测值之间具有良好的一致性。受试者工作特征曲线下面积为0.891(95%置信区间:0.839 - 0.942),对卒中后感染具有预测价值。选择最佳截断值时,灵敏度和特异度分别为87.5%和79.7%。
年龄、糖尿病、意识障碍、入院时NIHSS评分、侵入性手术及COPD是AIS后卒中后感染的危险因素。基于这些因素建立的列线图预测模型具有较高的区分度和准确性。