Analysis Of Risk Factors Of Spontaneous Intracerebral Hemorrhage Complicated With Nosocomial Pulmonary Infection And Preliminary Construction Of Risk Prediction Model

Objective:To evaluate the risk of nosocomial pulmonary infection in patients with spontaneous intracerebral hemorrhage(ICH),the risk factors of nosocomial pulmonary infection were explored and the risk prediction model was preliminarily constructed.Methods:The medical records of 514 patients with spontaneous intracerebral hemorrhage admitted to the Department of Neurosurgery and Department of Neurology of Nanchong Central Hospital from July 2020 to May 2021 were retrospectively analyzed,and they were divided into infection group(H group)and non-infection group(NH group)according to whether nosocomial lung infection occurred.(1)The general information,past,personal history,admission conditions and clinical diagnosis and treatments of patients in the two groups were collected from 4 aspects,19 indicators;(2)Univariate analysis of risk factors for spontaneous intracerebral hemorrhage complicated with nosocomial pulmonary infection;(3)Factors with significant differences in appeal were included in the multivariate logistic regression equation for further independent risk factor analysis;(4)Construct the line chart model of risk prediction by R language;(5)Receiver operating characteristic(ROC)curve and decision curve analysis(DCA)curve were used to evaluate the model.Results:(1)In 514 patients,102 patients were complicated with nosocomial pulmonary infection(19.84%).(2)Univariate analysis showed that age,history of hypertension,history of copd,vomiting,disturbance of consciousness,severity of stroke,dysphagia,type of nutritional support,use of acid inhibitors,indplacement of gastric tube and invasive assisted breathing were risk factors for spontaneous intracerebral hemorrhage complicated with nosocomial pulmonary infection(P<0.05);(3)Multivariate regression analysis showed that age,history of hypertension,history of copd,disturbance of consciousness,dysphagia,indurating gastric tube and invasive assisted breathing were independent risk factors for spontaneous ich complicated with nosocomial pulmonary infection(P<0.05).(4)This study was based on the general information,past,personal history,condition at admission,and clinical treatments of the patients.The area under ROC curve of the line graph prediction model established by various factors was 0.851.DCA curve showed that the net benefit of using this model was always higher than the benefit of all clinical intervention or no intervention,suggesting that this rograph can be used to predict the risk of spontaneous intracerebral hemorrhage complicated with nosocomial pulmonary infection.Conclusion:Age,history of hypertension,history of copd,disturbance of consciousness,dysphagia,indurating gastric tube and invasive assisted breathing may be independent risk factors for spontaneous intracerebral hemorrhage complicated with nosocomial pulmonary infection(P<0.05).The risk prediction model constructed based on the above factors is simple,intuitive,and has good differentiation and clinical practicability.It can better predict and evaluate the risk of nosocomial pulmonary infection in patients with spontaneous ich,and provide reference for the prospective intervention of medical staff.