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创伤性脑损伤后医院获得性肺炎的危险因素分析及预测模型构建

Risk factors analysis and prediction model construction of hospital-acquired pneumonia after traumatic brain injury.

作者信息

Wei Xiao-Cong, Zhang Yi-Zi, Guo Min, Tong Hai-Bo, Wang Yong-Hong, Wang Xiao-Qin, Ji Hong-Ming, Ren Bin, Wu Hao

机构信息

Shanxi Bethune Hospital, Shanxi Academy of Medical Sciences, Tongji Shanxi Hospital, Third Hospital of Shanxi Medical University, Taiyuan, China.

Shanxi Provincial People's Hospital, Taiyuan, China.

出版信息

Front Neurol. 2025 Jul 10;16:1518599. doi: 10.3389/fneur.2025.1518599. eCollection 2025.

Abstract

BACKGROUND

Hospital-acquired pneumonia (HBP) is a common and serious infections disease that affects the patients with traumatic brain injury (TBI). Severe pneumonia can lead to high mortality and morbidity in TBI patients. Therefore, it is important to investigate the risk factors and develop a prediction model for HBP following TBI.

METHODS

The clinical data of 285 patients with TBI, admitted to Shanxi Bethune Hospital and Shanxi Provincial People's Hospital, were collected. Patients were divided into two groups based on the presence or absence of pneumonia. Risk factors for HBP were identified, a predictive model was constructed, and its performance was validated.

RESULTS

Significant differences were observed between the pneumonia and non-pneumonia groups regarding several factors, including age, history of diabetes, smoking history, white blood cell count, platelet count, albumin levels, Glasgow Coma Scale (GCS) score upon admission, thoracic trauma, craniocerebral surgery, and the need for tracheal intubation post-admission ( < 0.05). Among these, age, smoking history, thoracic trauma, white blood cell count, albumin levels, and admission GCS score were identified as independent risk factors for HBP following TBI. The predictive model based on these six factors demonstrated high accuracy.

CONCLUSION

Age, smoking history, thoracic trauma, white blood cell count, albumin levels, and admission GCS score are independent risk factors for HBP after TBI. The predictive model developed based on these factors shows strong predictive accuracy and clinical utility.

摘要

背景

医院获得性肺炎(HBP)是一种常见且严重的感染性疾病,会影响创伤性脑损伤(TBI)患者。严重肺炎可导致TBI患者的高死亡率和高发病率。因此,研究TBI后HBP的危险因素并建立预测模型很重要。

方法

收集了山西白求恩医院和山西省人民医院收治的285例TBI患者的临床资料。根据是否患有肺炎将患者分为两组。确定HBP的危险因素,构建预测模型,并验证其性能。

结果

肺炎组和非肺炎组在几个因素上存在显著差异,包括年龄、糖尿病史、吸烟史、白细胞计数、血小板计数、白蛋白水平、入院时的格拉斯哥昏迷量表(GCS)评分、胸部创伤、颅脑手术以及入院后气管插管的需求(<0.05)。其中,年龄、吸烟史、胸部创伤、白细胞计数、白蛋白水平和入院GCS评分被确定为TBI后HBP的独立危险因素。基于这六个因素的预测模型显示出高准确性。

结论

年龄、吸烟史、胸部创伤、白细胞计数、白蛋白水平和入院GCS评分是TBI后HBP的独立危险因素。基于这些因素开发的预测模型具有很强的预测准确性和临床实用性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/95e2/12286833/26067b46df24/fneur-16-1518599-g001.jpg

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