| 摘要: |
| 目的 构建血液透析相关感染风险调整模型，创新医院感染监管。方法 对某三甲医院2014年1月—2015年3月血液透析的慢性肾衰竭患者数据（构建样本305个和验证样本98格），运用Logistic回归构建风险调整模型并检验，同时利用验证样本验证模型可靠性。结果 构建样本院感率为20.66%，住院日、在多家医院血液透析过、输血、激素为风险调整因素（OR=1.08、4.49、2.77、8.78；P=0.000、0.000、0.005、0.000；95%CI=[0.04，0.12]、[0.80，2.20]、[1.23，3.11]、[0.31，1.73]),模型拟合优度P=0.82，ROC曲线下面积为0.76。结论 依据4个风险调整因素可构建血液透析相关感染风险调整模型，创新医院感染监管，提高医疗质量。 |
| 关键词: 血液透析 医院感染 风险调整 医疗质量 |
| DOI： |
|
| 基金项目: |
|
| A Study on the Regulation of Hemodialysis Associated Infection Based on a Risk-Adjustment Model |
|
| () |
| Abstract: |
|
Objective To derive a risk-adjustment model of hemodialysis associated infection(HAI) for the healthcare-associated infection(HCAI) regulation innovation. Method Data of hemodialysis patients with chronic renal failure in 2014.1—2015.3 was collected(305 derivation sample and 98 validation sample) in a tertiary hospital. Logistic regression model was used to derive a risk-adjustment model and a validation sample was also used to validate the model. Result HAI developed in 20.66% of the derivation sample. Length of stay，receiving hemodialysis in more than one hospital，blood transfusions and using hormone before infection were found to be associated with infection(OR=1.08、4.49、2.77、8.78；P=0.000、0.000、0.005、0.000；95%CI=[0.04，0.12]、[0.80，2.20]、[1.23，3.11]、[0.31-1.73]). Goodness of fit，P=0.82 and the area under ROC was 0.76. Conclusion A risk-adjustment model can be developed based on four risk factors. It may provide a method to innovative HCAI regulation and to promote quality of care. |
| Key words: hemodialysis,healthcare-associated infection,risk adjustment,quality of care |
