Construction And Evaluation Of Risk Prediction Model For Urinary Tract Infection After Intracranial Hemorrhage Surgery

Objective:Analyze and study the causes of postoperative urinary tract infection in patients with intracranial hemorrhage,and design a model to predict the risk of postoperative urinary tract infection in patients with intracranial hemorrhage.Methods: 354 patients with intracranial hemorrhage who were treated in neurosurgery department of a Class III hospital in Anhui Province from March 2019 to May 2021 were divided into urinary tract infection group(n=65)and non-urinary tract infection group(n=289)according to whether there was urinary tract infection after operation.Collect and sort out patients’ preoperative details,such as physical characteristics,education level,gender and age,diabetes history,surgery history,smoking history,preoperative Glasgow Coma Scale(GCS),blood glucose value at admission,white blood cell count,preoperative hemoglobin,preoperative albumin);Intraoperative data(operation site,operation time,anesthesia time,Intraoperative bleeding volume);Postoperative laboratory data(Creatinine,blood calcium,blood magnesium,blood sodium,uric acid,p H,D-dimer,fibrinogen),and postoperative data(mechanical ventilation,tracheotomy,intracranial infection,head drainage tube).Single factor analysis and logistic regression analysis were used to establish a Nomograph model to predict the occurrence of urinary tract infection in patients with intracranial hemorrhage after operation.The accuracy and validity of the Nomograph model is verified by the Nonparametric repeated sampling method(Bootstrap resampling times=500),the Nomograph model is checked by the method of Hosmer-Lemeshow goodness of fit test and evaluation,and the area under the curve of the model is calculated by the ROC curve to evaluate the accuracy of the prediction of the model.Results:A total of 360 patients were included in this study,354 of whom had complete and effective survey data,with an effective rate of 98.33%.Among the investigated patients with intracranial hemorrhage after operation,65 patients developed urinary tract infection,and the incidence of postoperative urinary tract infection was 18.36%.The results of univariate analysis showed that there were some differences in intracranial interference between the two groups in terms of age,male,history of hypertension,history of diabetes,preoperative GCS score,preoperative hemoglobin,blood glucose value at admission,operation time,anesthesia time,intraoperative bleeding,blood calcium,blood magnesium,blood sodium,D-dimer,tracheotomy,and statistics.According to multivariate logistic regression analysis,age(OR=1.026,95%CI: 1.002-1.051),male(OR=0.407,95% CI: 0.212-0.783),history of diabetes(OR=2.481,95% CI: 1.166-5.279),operation time(OR=1.006,95% CI: 1.002-1.009),D-dimer(OR=1.238,95% CI: 1.118-1.371)Postoperative intracranial infection(OR=2.533,95% CI: 1.276～5.031)is an independent influencing factor of postoperative urinary tract infection in patients with intracranial hemorrhage.The area under the curve of the Nomograph model to predict the occurrence of urinary tract infection after intracranial hemorrhage surgery was 0.773,95% CI was 0.711～0.834,sensitivity was74.00%,specificity was 80.00%.Conclusions: This paper focuses on the analysis of the main factors that lead to postoperative urinary tract infection in patients with intracranial hemorrhage.The study found that the age,medical history,operation time,D-dimer and postoperative intracranial infection of patients were independent risk factors for postoperative urinary tract infection in patients with intracranial hemorrhage,and men were independent protective factors for postoperative urinary tract infection in patients with intracranial hemorrhage.By designing a Nomograph model,the main factors that lead to postoperative urinary tract infection in patients with intracranial hemorrhage are displayed more intuitively,and the risk of postoperative urinary tract infection is predicted.The prediction tool is provided for clinical medical staff in treatment and nursing decisions,and the probability of postoperative urinary tract infection in patients with intracranial hemorrhage is reduced.