失禁性皮炎风险预测模型的构建及验证研究

摘要

：Objective To explore the risk factors of incontinent associated dermatitis(IAD)in critically ill patients, and to construct a model with good predictive function, providing the best assessment tool for clinical practice. Methods 〓Critically ill patients admitted to three general hospital intensive care units from December, 2016 to December, 2017 were recruited in this study. A two-phase methodology was conducted and a sample of 300 critically ill patients was included in the first phase of the study. A predictive model was established based on the risk factors analysis of IAD. In the second phase of the study, the predictive model was used to estimate the risk of IAD among critically ill patients recruited between September 2017 and December 2017, and the sensitivity, specificity and predictive power of the predictive model were analyzed. Results 〓A total of 468 patients were included, including 300 in the first phase of the study and 168 in the second phase of study. Logistic regression analysis showed that age, APACHE II score, hemoglobin, SpO2, multiple drug-resistant infections, and replacement frequency of nursing mat were risk factors for IAD(P0.05). The ROC curve showed that when the optimal cutoff value of the predictive model was 0.50, it had predictive value for the occurrence of IAD in critically ill patients. The sensitivity at this time was 71.43%, the specificity was 88.57%, and the Youden index was 0.60. The area under the curve was 0.904(95% CI: 0.86-0.95). Conclusion 〓In this study, the predictive model based on the risk factors has high sensitivity and specificity, which can better identify high-risk patients with IAD, and provide some theoretical support for clinical nursing practice.