Establish A Model For Predicting The Initial Therapeutic Effect Of Hospital-acquired Methicillin-resistant Staphylococcus Aureus Pneumonia

Objective To explore factors associated with the initial therapeutic effect of hospital acquired methicillin-resistant Staphylococcus aureus pneumonia(MRSA-HAP)and establish a prediction model.Methods The retrospective analysis included 137 patients with MRSA-HAP in Peking Union Medical College Hospital from 2014 to 2020 to analyze clinical indicators,laboratory indicators and treatment factors and establish a prediction model.Result 86 males and 51 females from 18 to 80 years old were included.By Logistic regression analysis,shock,APACHE Ⅱ score,heart rate and blood-stream infection were independent risk factors(The AUC were 0.702,0.700,0.614,0.662,the sensitivity were 0.661,0.525,0.305.0.664,the specificity were 0.744,0.782,0.923,0.679,the prediction accuracy were 70.80%,62.04%,65.69%,66.42%,respectively).The prediction model:P=1.51*A+0.12*B+1.15*C+1.46*D-4.08(If shock is present,A=1;B=APACHE Ⅱ score;if heart rate is more than 100bpm,C=1;if bloodstream infection is present,D=1.When P>0,the risk of initial treatment failure increases).The AUC,sensitivity,specificity and prediction accuracy of the model are 0.841,0.881,0.654 and 75.91%,respectively.Conclusion Shock,bloodstream infection,increased APACHE II score and heart rate>100bpm are independent risk factors for initial treatment failure of MRSAHAP.