| 邹盼盼,吴丹,钱金平,徐翠凤,王文,钱国安.成人外周静脉留置针导管失效风险列线图预测模型的构建[J].上海护理,2024,24(2): |
| 成人外周静脉留置针导管失效风险列线图预测模型的构建 |
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| DOI： |
| 中文关键词: 成人 静脉留置针 导管失效 列线图 风险预测 |
| 英文关键词: |
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| 中文摘要: |
| 摘要:目的 探讨成人外周静脉留置针导管失效的风险因素，为针对性干预提供参考。方法 选取某省6家医院的1022例置入外周静脉留置针的患者，运用Logistic回归分析探索成人外周静脉留置针导管失效的风险因素，并绘制列线图模型.用Bootstrap重抽样法进行内部验证，用受试者工作特征曲线下面积(receiver operating characteristic curve,ROC)和霍斯默(Hosmer-Lemeshow,H-L)拟合优度检验评价模型的预测效果。结果 成人外周静脉留置针导管失效的独立风险因素包括获得外周静脉导管维护资质的院内培训护士、患者所在科室为外科、健康教育依从性差的患者、使用＞20G留置针、使用开放型留置针、穿刺侧肢体活动受限、患者主诉异常、输注刺激性药物、日输液总量≥1500ml;其模型ROC曲线下面积为0.731 (95%CI:0.700~0.762 )，内部验证后C-指数为0.722( 95%CI:0.691~0.753 )，H-L检验结果显示为χ2=3.414，P=0.755。结论 本研究构建风险预测模型具有良好的预测效能，能为临床早期甄别外周静脉留置针导管失效的高危人群提供参考。 |
| 英文摘要: |
| Abstract：Objective To investigate the risk factors for the failure of peripheral venous indwelling needle catheters in adults, and to provide reference for targeted intervention.Methods A total of 1022 patients with peripheral venous indwelling needles from 6 hospitals in Anhui Province were
selected. Logistic regression analysis was used to explore the risk factors of peripheral venous indwelling needle catheter failure in adults, and a nomogram model was drawn. The Bootstrap resampling method was used for internal validation and the area under the receiver operating characteristic curve (ROC) and the Hosmer-Lemeshow (H-L) goodness of fit test were used to evaluate the predictive effect of the model.Results The independent risk factors of peripheral venous indwelling catheter failure in adults included inhospital trained nurses who were qualified to maintain peripheral venous catheters, the patient's department was surgery, patients with poor compliance with health education, the use of >20G indwelling needles, the use of open indwelling needles, puncture Limitation of lateral limb movement, abnormal complaints of patients, infusion of irritating drugs, and total daily infusion of ≥1500ml; the area under the model ROC curve was 0.731 (95% CI: 0.700 ~ 0.762), the C-index after internal validation was 0.722 ( 95%CI: 0.691~0.753 ),and the H-L test results showed thatχ2=3.414, P=0.755.Conclusion The risk prediction model constructed in this study has good predictive performance and can provide a reference for early clinical identification of high-risk groups of indwelling needle catheter failure. |
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