某三级医院10年医院感染现患率变化趋势及多因素分析
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R181.3+2

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广西壮族自治区卫生健康委员会自筹经费科研课题(Z20210521)


Changing trend and multivariate analysis of prevalence rates of healthcare-associated infection in a tertiary hospital for 10 years
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    摘要:

    目的 描述某三级医院的医院感染现患率及相关因素在10年间的变化趋势,分析医院感染的影响因素。方法 2013—2022年开展连续10年(每年选择一天作为调查日)的医院感染横断面调查并收集数据,采用趋势χ2检验、Pearson相关系数对医院感染现患率和相关因素分布进行趋势分析,建立多因素logistic回归和多层感知器模型(multilayer perceptron, MLP)分析因素的独立效应和重要性。结果 该医院2013—2022年医院感染现患率为4.66%~8.07%,呈线性上升趋势。ICU患者比例、调查日前近2 d内中心静脉导管的使用率呈线性上升趋势,而调查日前近2 d内留置导尿管的患者比例、近30 d内接受手术的患者比例下降。MLP显示医院感染患病前三位重要因素分别是住院时间>10 d、入住ICU和近2 d内留置中心静脉导管。多因素logistic回归模型表明,住院时间>10 d、调查日近2 d内留置中心静脉导管或导尿管、近30 d内手术史、入住ICU是医院感染的独立影响因子。结论 该医院近10年来医院感染现患率呈线性上升趋势,应通过目标性监测进一步分析原因并确定干预方向。运用趋势检验统计分析方法和logistic回归、MLP等多因素模型,能进一步发掘医院感染现患率调查的数据价值。

    Abstract:

    Objective To describe the changing trend and related factors of prevalence rates of healthcare-associa-ted infection (HAI) in a tertiary hospital in the past 10 years, and analyze the influencing factors for HAI. Methods A cross-sectional survey on HAI was conducted for 10 consecutive years from 2013 to 2022 (one day was selected as the survey day each year), data were collected. The distribution and related factors of prevalence rates of HAI were analyzed by trend-χ2 test and Pearson correlation coefficient. Multivariate logistic regression and multilayer perceptron (MLP) models were constructed to analyze the independent effect and significance of factors. Results From 2013 to 2022, the prevalence rates of HAI ranged from 4.66% to 8.07% in this hospital, showing a linear upward trend. The proportions of ICU patients and utilization rate of central venous catheters within 2 days before the survey showed linear upward trends, while the proportion of patients with urinary catheters within 2 days before the survey and proportion of patients undergoing surgery within 30 days before the survey decreased. The MLP model revealed that the top 3 important factors for HAI were length of hospital stay >10 days, admission in ICU, and indwelling central venous catheters within 2 days before the survey. Multivariate logistic regression model indicated that length of hospital stay >10 days, indwelling central venous catheters or urinary catheters within 2 days before the survey, surgery within 30 days before the survey, and admission in ICU were independent influencing factors for HAI. Conclusion The incidence of HAI in this hospital presents a linear increase in recent 10 years, the causes should be further analyzed and the direction of intervention should be determined through targeted surveillance. Adopting trend test statistical analysis method, logistic regression, MLP multi-factor model can further explore the data value of HAI prevalence survey.

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周子筌,覃金爱,黄娟,等.某三级医院10年医院感染现患率变化趋势及多因素分析[J]. 中国感染控制杂志,2024,23(9):1135-1141. DOI:10.12138/j. issn.1671-9638.20245142.
ZHOU Zi-quan, QIN Jin-ai, HUANG Juan, et al. Changing trend and multivariate analysis of prevalence rates of healthcare-associated infection in a tertiary hospital for 10 years[J]. Chin J Infect Control, 2024,23(9):1135-1141. DOI:10.12138/j. issn.1671-9638.20245142.

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  • 收稿日期:2023-12-07
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  • 在线发布日期: 2024-09-30
  • 出版日期: 2024-09-28