Yao Jing, Bao Xiao-Jian, Zhang Ya-Feng, Wu Bin, Wu Qi-Shun
Department of Public Health, Affiliated Hospital of Jiangsu University,Zhenjiang,Jiangsu 212000,China.
Department of Medical Management, Affiliated Hospital of Jiangsu University,Zhenjiang,Jiangsu 212000,China.
Zhongguo Yi Xue Ke Xue Yuan Xue Bao. 2025 Apr 30;47(2):244-250. doi: 10.3881/j.issn.1000-503X.16160.
Objective To analyze the risk factors for prolonged length of hospital stay in patients with peritoneal dialysis associated peritonitis(PDAP)and construct a nomogram based on Logistic regression model.Methods A retrospective study was conducted on patients with PDAP who were hospitalized at the Affiliated Hospital of Jiangsu University from January 2013 to December 2023.Using the 75th percentile of hospitalization time as the cutoff(>21 days),the patients were divided into prolonged length of hospital stay group and normal length of hospital stay group.Clinical data were compared between the two groups.Logistic regression analysis was used to analyze the risk factors for prolonged hospital stay in PDAP patients and to construct a nomogram.Results A total of 131 PDAP patients were included in this study,including 40 cases in prolonged length of hospital stay group and 91 cases in normal length of hospital stay group.Multivariate Logistic regression analysis showed that Gram-negative bacteria detected in ascites(=6.012,95% =1.878-19.248,=0.003)and elevated platelet count(=1.010,95% =1.005-1.015,<0.001)were independent risk factors for prolonged length of hospital stay,while elevated serum chloride(=0.885,95% =0.802-0.978,=0.016)was a protective factor.Based on the above three indicators,a nomogram was constructed.The multivariate Logistic regression model showed an area under the receiver operating characteristic curve(AUC)of 0.755,with an internal validation AUC of 0.727 using the Bootstrap method.The calibration curve indicated that the predicted probability was consistent with the actual probability.The decision curve showed that the model was clinically applicable when the threshold probabilities were 9%-10%,13% and 18%-92%.Conclusion A nomogram,based on the detection of gram-negative bacteria in ascites,platelet count and serum chloride,was helpful for clinical screening PADP patients at risk for prolonged length of hospital stay,and can provide a basis for optimizing clinical decision-making.
目的 分析腹膜透析相关性腹膜炎（PDAP）患者住院时间延长的危险因素，并基于Logistic回归模型构建列线图。方法 对2013年1月至2023年12月在江苏大学附属医院住院的PDAP患者进行回顾性研究。以住院时间的第75百分位数作为截断值（>21天），将患者分为住院时间延长组和住院时间正常组。比较两组的临床资料。采用Logistic回归分析PDAP患者住院时间延长的危险因素并构建列线图。结果 本研究共纳入131例PDAP患者，其中住院时间延长组40例，住院时间正常组91例。多因素Logistic回归分析显示，腹水中检测到革兰阴性菌（β=6.012，95%CI=1.878-19.248，P=0.003）和血小板计数升高（β=1.010，95%CI=1.005-1.015，P<0.001）是住院时间延长的独立危险因素，而血清氯升高（β=0.885，95%CI=0.802-0.978，P=0.016）是保护因素。基于上述三个指标构建了列线图。多因素Logistic回归模型的受试者工作特征曲线（AUC）下面积为0.755，采用Bootstrap法进行内部验证的AUC为0.727。校准曲线表明预测概率与实际概率一致。决策曲线显示，当阈值概率为9%-10%、13%和18%-92%时，该模型具有临床适用性。结论 基于腹水中革兰阴性菌检测、血小板计数和血清氯构建的列线图有助于临床筛查有住院时间延长风险的PADP患者，并可为优化临床决策提供依据。
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