Objective To investigate the risk factors of hospital-associated infection (HAI) in elderly patients with hypertension and diabetes mellitus, and to establish a nomogram model for HAI.
Methods A retrospective study was performed to analyze the clinical data of 148 elderly patients with hypertension complicated with diabetes mellitus. The patients were divided into the HAI group and non-HAI group according to occurrence of HAI. Univariate analysis and multivariate Logistic regression analysis were used to screen out the independent risk factors of HAI occurrence. Then, each factor was scored by Nomogram method to construct the prediction model. Receiver operating characteristic (ROC) curve was drawn to assess the predictive value of the established Nomogram. Furthermore, the predictive ability of the Nomogram model was internally validated by calculating the C-index and the calibration plot was drawn.
Results The mean age of 148 patients was (64.21±12.84) years, and 32 patients (21.62%) developed HAI. Univariate analysis showed that the occurrence of HAI was correlated with age, smoking, disease duration of comorbidities, blood pressure and blood glucose control state, other underlying diseases, APAHEⅡ scores, consciousness state and albumin levels (P < 0.05). The multivariate Logistic regression analysis showed that disease duration of comorbidities ≥10 years (OR=3.589, 95%CI, 1.056~12.193, P=0.041), blood glucose control substandard (OR=4.538, 95%CI, 1.287~16.002, P=0.019), other underlaying diseases (OR=8.893, 95%CI, 2.624~30.132, P < 0.001), APACHEⅡ score ≥20 (OR=6.259, 95%CI, 1.934~20.256, P=0.002), consciousness disorder (OR=9.365, 95%CI, 2.744~34.477, P=0.001) were independent risk factors for HAI occurrence. Based on above risk factors in Nomogram model, statistical analysis showed that this model had a good discrimination, C-index value and the area under the ROC curve, indicating that the nomogram model had better predictive performance and differentiation.
Conclusion The disease duration of comorbidities ≥10 years, substandard blood glucose control, other underlying diseases, APACHEⅡscore ≥20, consciousness disorder are independent risk factors for HAI occurrence in in elderly patients with hypertension and diabetes mellitus. Nomogram model based on these risk factors has good predictive efficacy and important clinical value, and can provide reference for prevention and control of HAI.
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