摘要
目的探究腺病毒肺炎患儿出院延迟的相关危险因素并构建模型,以期缩短腺病毒肺炎患儿的住院时间及出院延迟的干预方案制定提供参考。方法回顾性分析2022年8月—2024年2月本院收治的237例腺病毒肺炎患儿临床资料,根据患儿住院时间(以住院10 d为分界点,即<10 d或≥10 d)将其分为出院延迟组和非出院延迟组,采用单因素分析和多因素Logistic回归分析筛选腺病毒肺炎患儿出院延迟的影响因素。结果共计有41例患儿发生了出院延迟,出院延迟发生率为17.30%(41/237);出院延迟组和非出院延迟组患儿年龄、住院期间发热时间、病情严重程度、C反应蛋白、降钙素原等临床资料对比,差异具有统计学意义(P<0.05);经多因素Logistic回归分析显示,年龄(OR=3.305,95%CI:1.450~7.534)、住院期间发热时间(OR=3.822,95%CI:1.492~9.790)、病情严重程度(OR=3.574,95%CI:1.458~8.760)、C反应蛋白(OR=1.061,95%CI:1.005~1.119)、降钙素原(OR=24.796,95%CI:6.155~99.891)均是腺病毒肺炎患儿出院延迟的独立危险因素,差异具有统计学意义(P<0.05)。概率预测模型P=1/[1+e^(-^((-14.041+1.196*X1+1.341*X2+1.274*X3+0.059*X4+3.211*X5)))],模型预测总体正确性为88.3%。Omnibus检验的结果显示P<0.001。经过5折交叉验证,预测正确率为74.1%。结论年龄、住院期间发热时间、病情严重程度、C反应蛋白、降钙素原均是腺病毒肺炎患儿出院延迟的影响因素,医护人员可根据上述因素,给予出院延迟高危人群重点关注并制定相应的预防措施,继而有助于提高临床治疗效果,缩短患儿住院时间。
Objective To explore the risk factors associated with delayed discharge in children with adenovirus pneumonia and construct a model to provide reference for reducing hospitalization time and developing intervention plans for delayed discharge in children with adenovirus pneumonia.Methods A retrospective analysis was conducted on the clinical data of 237 children with adenovirus pneumonia admitted to the Children's Hospital of Nanjing Medical University from August 2022 to February 2024.The patients were divided into a delayed discharge group and a non-delayed discharge group based on their hospitalization time(with 10 days as the cut-off point,i.e.,<10 days or≥10 days).Univariate analysis and multivariate Logistic regression analysis were used to screen the influencing factors of delayed discharge in children with adenovirus pneumonia.Results A total of 41 patients had delayed discharge,the incidence of delayed discharge was 17.30%(41/237).There were significant differences in age,fever duration during hospitalization,severity of disease,C-reactive protein and procalcitonin between the delayed discharge group and the non-delayed discharge group(P<0.05).Multivariate Logistic regression analysis showed that age(OR=3.305,95%CI:1.450-7.534),duration of fever during hospitalization(OR=3.822,95%CI:1.492-9.790),severity of disease(OR=3.574,95%CI:1.458-8.760),C-reactive protein(OR=1.061,95%CI:1.005-1.119),procalcitonin(OR=24.796,95%CI:6.155~99.891)were independent risk factors for delayed discharge in children with adenovirus pneumonia,and the difference was statistically significant(P<0.05).Probabilistic prediction model P=1/[1+e^(-^((-14.041+1.196*X1+1.341*X2+1.274*X3+0.059*X4+3.211*X5)))],the overall accuracy of the model prediction is 88.3%.The result of Omnibus test showed P<0.001.The accuracy of prediction was 74.1%after the cross-validation of 5 fold.Conclusion Age,non-standard medication use before admission,fever duration during hospitalization,disease severity,CRP,and PCT are all influencing factors for delayed discharge in children with adenovirus pneumonia.Healthcare professionals can focus on high-risk individuals for delayed discharge based on these factors and formulate corresponding preventive measures,which may help improve clinical treatment outcomes and shorten hospitalization time.
作者
陈玉洁
赵旭
刘文静
诸白美
CHEN Yujie;ZHAO Xu;LIU Wenjing;ZHU Baimei(Department of Emergency Medicine,Children's Hospital Affiliated to Nanjing Medical University,Nanjing 210008,China;Department of Nephrology,Children's Hospital Affiliated to Nanjing Medical University,Nanjing 210008,China)
出处
《西部医学》
2025年第9期1369-1373,共5页
Medical Journal of West China
基金
南京市卫生科技发展专项资金项目(YKK22170)。
关键词
腺病毒肺炎
儿童
出院延迟
危险因素
Adenovirus pneumonia
Children
Delayed discharge
Risk factor
