Establishment of a risk prediction model for catheter-associated urinary tract infection in elderly critically ill patients

ZHU Rui; TIAN Yali; HUANG Min; CHU Minjuan

doi:10.7619/jcmp.20243686

Journal of Clinical Medicine in Practice > 2024 > 28(24): 143-148. > DOI: 10.7619/jcmp.20243686

ZHU Rui, TIAN Yali, HUANG Min, CHU Minjuan. Establishment of a risk prediction model for catheter-associated urinary tract infection in elderly critically ill patients[J]. Journal of Clinical Medicine in Practice, 2024, 28(24): 143-148. DOI: 10.7619/jcmp.20243686

Citation:

PDF (1378 KB)

Establishment of a risk prediction model for catheter-associated urinary tract infection in elderly critically ill patients

Department of Geriatric ICU, Jiangsu Provincial People's Hospital, Nanjing, Jiangsu, 210029

More Information

Received Date: August 20, 2024
Revised Date: October 09, 2024

Graphical Abstract

Abstract

Abstract

Objective
To analyze the risk factors for catheter-associated urinary tract infection (CAUTI) in elderly critically ill patients and construct a related risk prediction model.
Methods
Clinical materials of 8 905 patients with catheterization in the geriatric ICU ward of Jiangsu Provincial People's Hospital from January 2014 to June 2024 were retrospectively collected. The patients were divided into infection group (n=114) and non-infection group (n=8 791) based on the occurrence of CAUTI. Multivariate Logistic regression analysis was used to identify the risk factors for CAUTI, and a Nomogram prediction model was constructed. Internal validation was performed by the receiver operating characteristic (ROC) curve, calibration curve, and Hosmer-Lemeshow goodness-of-fit test to assess the discrimination and calibration of the prediction model.
Results
In this study, the incidence of CAUTI in elderly critically ill patients was 2.55‰. Multivariate Logistic regression analysis showed that age, consciousness status, renal dysfunction, duration of catheterization, and the number of catheter insertions were independent influencing factors for CAUTI in elderly critically ill patients. A Nomogram model was constructed based on the results of the regression analysis. Area under the curve (AUC) of ROC curve for internal validation by the Bootstrap method was 0.802 (95%CI, 0.796 to 0.809). The calibration curve was close to the standard curve, and the predicted values were generally consistent with the actual values, demonstrating good predictive performance of the model.
Conclusion
Age, renal dysfunction, consciousness status, duration of catheterization, and the number of catheter insertions are independent influencing factors for CAUTI in elderly critically ill patients. Nomogram prediction model established based on these factors is simple and feasible, with reliable predictive performance.
- elderly critically ill people,
- catheter-associated urinary tract infection,
- Nomogram,
- prediction model

FullText(HTML)

References (28)

References

[1]	NOREN HOOTEN N, PACHECO N L, SMITH J T, et al. The accelerated aging phenotype: the role of race and social determinants of health on aging[J]. Ageing Res Rev, 2022, 73: 101536. doi: 10.1016/j.arr.2021.101536
[2]	BRUNKER L B, BONCYK C S, RENGEL K F, et al. Elderly patients and management in intensive care units (ICU): clinical challenges[J]. Clin Interv Aging, 2023, 18: 93-112. doi: 10.2147/CIA.S365968
[3]	BUETTI N, TABAH A, TIMSIT J F, et al. What is new in catheter use and catheter infection prevention in the ICU[J]. Curr Opin Crit Care, 2020, 26(5): 459-465. doi: 10.1097/MCC.0000000000000754
[4]	SHEN L, FU T, HUANG L G, et al. 7295 elderly hospitalized patients with catheter-associated urinary tract infection: a case-control study[J]. BMC Infect Dis, 2023, 23(1): 825. doi: 10.1186/s12879-023-08711-0
[5]	魏楠, 王力红, 赵霞, 等. 老年患者导尿管相关尿路感染风险预测评分模型构建与验证[J]. 中国感染控制杂志, 2018, 17(10): 907-912.
[6]	RUBI H, MUDEY G, KUNJALWAR R. Catheter-associated urinary tract infection (CAUTI)[J]. Cureus, 2022, 14(10): e30385.
[7]	中华人民共和国卫生部. 导尿管相关尿路感染预防与控制技术指南(试行)[S]. 北京: 2010.
[8]	HANSTED A K, M∅LLER M H, M∅LLER A M, et al. APACHE Ⅱ score validation in emergency abdominal surgery. A post hoc analysis of the InCare trial[J]. Acta Anaesthesiol Scand, 2020, 64(2): 180-187. doi: 10.1111/aas.13476
[9]	JIANG W. Depression and cardiovascular disorders in the elderly[J]. Clin Geriatr Med, 2020, 36(2): 211-219. doi: 10.1016/j.cger.2019.11.003
[10]	TANDOGDU Z, WAGENLEHNER F M E. Global epidemiology of urinary tract infections[J]. Curr Opin Infect Dis, 2016, 29(1): 73-79. doi: 10.1097/QCO.0000000000000228
[11]	ZILBERBERG M D, NATHANSON B H, SULHAM K, et al. Descriptive epidemiology and outcomes of hospitalizations with complicated urinary tract infections in the United States, 2018[J]. Open Forum Infect Dis, 2022, 9(1): ofab591. doi: 10.1093/ofid/ofab591
[12]	REDDER J D, LETH R A, M∅LLER J K. Analysing risk factors for urinary tract infection based on automated monitoring of hospital-acquired infection[J]. J Hosp Infect, 2016, 92(4): 397-400. doi: 10.1016/j.jhin.2015.12.009
[13]	DETWEILER K, MAYERS D, FLETCHER S G. Bacteruria and urinary tract infections in the elderly[J]. Urol Clin North Am, 2015, 42(4): 561-568. doi: 10.1016/j.ucl.2015.07.002
[14]	GOMILA A, CARRATALÀ J, ELIAKIM-RAZ N, et al. Clinical outcomes of hospitalised patients with catheter-associated urinary tract infection in countries with a high rate of multidrug-resistance: the COMBACTE-MAGNET RESCUING study[J]. Antimicrob Resist Infect Control, 2019, 8: 198. doi: 10.1186/s13756-019-0656-6
[15]	GAGE H, AVERY M, FLANNERY C, et al. Community prevalence of long-term urinary catheters use in England[J]. Neurourol Urodyn, 2017, 36(2): 293-296. doi: 10.1002/nau.22961
[16]	SØRBYE L W, FINNE-SOVERI H, LJUNGGREN G, et al. Indwelling catheter use in home care: elderly, aged 65+, in 11 different countries in Europe[J]. Age Ageing, 2005, 34(4): 377-381. doi: 10.1093/ageing/afi094
[17]	CLARKE K, HALL C L, WILEY Z, et al. Catheter-associated urinary tract infections in adults: diagnosis, treatment, and prevention[J]. J Hosp Med, 2020, 15(9): 552-556. doi: 10.12788/jhm.3292
[18]	MONG I, RAMOO V, PONNAMPALAVANAR S, et al. Knowledge, attitude and practice in relation to catheter-associated urinary tract infection (CAUTI) prevention: a cross-sectional study[J]. J Clin Nurs, 2022, 31(1/2): 209-219.
[19]	CHEN X Y, HOLTZMAN D M. Emerging roles of innate and adaptive immunity in Alzheimer's disease[J]. Immunity, 2022, 55(12): 2236-2254. doi: 10.1016/j.immuni.2022.10.016
[20]	李飞, 宋美璇, 李显蓉. 长期留置导尿患者成功拔除导尿管的最佳指南意见[J]. 护理学报, 2018, 25(5): 1-5.
[21]	WANG L H, TSAI M F, HAN C S, et al. Is bladder training by clamping before removal necessary for short-term indwelling urinary catheter inpatient A systematic review and meta-analysis[J]. Asian Nurs Res, 2016, 10(3): 173-181. doi: 10.1016/j.anr.2016.07.003
[22]	许婷婷, 徐凤, 刘磊. 短期留置导尿管拔管前夹管训练的必要性和拔管时机的研究[J]. 当代护士, 2021, 28(8): 135-137.
[23]	FENELEY R C L, HOPLEY I B, WELLS P N T. Urinary catheters: history, current status, adverse events and research agenda[J]. J Med Eng Technol, 2015, 39(8): 459-470. doi: 10.3109/03091902.2015.1085600
[24]	COLLI J, TOJUOLA B, PATTERSON A L, et al. National trends in hospitalization from indwelling urinary catheter complications, 2001-2010[J]. Int Urol Nephrol, 2014, 46(2): 303-308. doi: 10.1007/s11255-013-0524-x
[25]	勾桢楠, 张晓菊, 陈雅琼, 等. 妇科肿瘤患者术后导尿管管理的循证实践[J]. 护士进修杂志, 2019, 34(1): 35-40.
[26]	BÜYÜKYILMAZ F, CULHA Y, ZÜMRELER H, et al. The effects of bladder training on bladder functions after transurethral resection of prostate[J]. J Clin Nurs, 2020, 29(11/12): 1913-1919.
[27]	胡雁, 杨英华. 关于"以实证为基础的护理"的理论与实践[J]. 中华护理杂志, 2001, 36(4): 245-248. doi: 10.3321/j.issn:0254-1769.2001.04.001
[28]	冯绍杰, 张淑香. 更换时间对长期留置导尿管患者的影响[J]. 齐鲁护理杂志, 2013, 19(3): 87-88.

[1]	LI Hongli, YAN Huili. Relationships of glucose metabolism with sex hormones and endometrial receptivity in patients with polycystic ovary syndrome at childbearing age[J]. Journal of Clinical Medicine in Practice, 2024, 28(10): 106-111. DOI: 10.7619/jcmp.20233856
[2]	LIU Xiaohong, LI Mei, WANG Fengyun, SI Yuchen, DU Xiaoli, SHI Liangliang, SHAO Haiou, CHEN Li, ZHANG Hongyan. Effect of modified Qiankun Yudan Decoction combined with leuprorelin acetate on serum carbohydrate antigen 125 and recurrence rate in patients with adenomyosis[J]. Journal of Clinical Medicine in Practice, 2023, 27(18): 133-137. DOI: 10.7619/jcmp.20231988
[3]	HUANG Dan, ZHU Yue, CUI Shuna. Value of inflammatory response indicators and tumor markers in predicting the prognosis of endometrial carcinoma patients undergoing surgery[J]. Journal of Clinical Medicine in Practice, 2023, 27(18): 26-31, 38. DOI: 10.7619/jcmp.20231381
[4]	WEI Weiwei, SHI Ruxia, MIN Yifei. Effect of laparoscopic surgery combined with gonadotropin-releasing hormone agonist in treatment of patients with adenomyoma of uterus[J]. Journal of Clinical Medicine in Practice, 2020, 24(23): 56-58. DOI: 10.7619/jcmp.202023018
[5]	XIAO Di, FU Yu, MENG Qi. Effects of levonorgestrel-releasing intrauterine system for dysmenorrhea patients with adenomyosis[J]. Journal of Clinical Medicine in Practice, 2020, 24(15): 51-54. DOI: 10.7619/jcmp.202015014
[6]	LIU Lingxiang, GAO Wen, LI Jun, HUANG Puwen, LIU Ping, SHU Yongqian. Analysis in clinical features and prognostic factors of 497 patients with endometrial cancer[J]. Journal of Clinical Medicine in Practice, 2016, (7): 86-89. DOI: 10.7619/jcmp.201607025
[7]	LI Yuping. The application of perioperative holistic nursing intervention in endometrial cancer patients[J]. Journal of Clinical Medicine in Practice, 2015, (10): 68-70,78. DOI: 10.7619/jcmp.201510021
[8]	LI Yanqi, CHEN Liping, WANG Zhixue. Expression of macrophage migration inhibitory factor in endometrial hyperplasia and type Ⅰ endometrial carcinoma and their correlation[J]. Journal of Clinical Medicine in Practice, 2013, (24): 72-74. DOI: 10.7619/jcmp.201324021
[9]	CHEN Jinghua, TANG Hui, YU Chuanhu, LI Wei. Research on recurrent situation and risk factors of endometrial cancer[J]. Journal of Clinical Medicine in Practice, 2013, (13): 145-147. DOI: 10.7619/jcmp.201313053
[10]	ZHU Suoyu, TAN Jie, YU Songmei. Clinical analysis of hysteroscopy in the treatment of 125 patient with endometrial polyps[J]. Journal of Clinical Medicine in Practice, 2012, (19): 79-80.

Cited By

Cited by

Periodical cited type(5)

1.	王烁. 胃十二指肠溃疡穿孔修补术护理对策及效果. 中国城乡企业卫生. 2025(03): 117-119 .
2.	翁昆仑，张鹏，张华甫. 经脐单孔腹腔镜胃十二指肠溃疡穿孔修补术治疗胃十二指肠溃疡穿孔患者的效果. 河南医学研究. 2023(21): 3964-3967 .
3.	蒲江玲. 早期营养支持护理联合健康教育在胃十二指肠溃疡穿孔患者中的应用效果. 中国当代医药. 2022(06): 189-192 .
4.	王佳佳. 急性胃十二指肠溃疡穿孔术后感染危险因素分析. 中国烧伤创疡杂志. 2022(02): 116-119 .
5.	刘俊. 分析整体护理运用于十二指肠溃疡患者的护理效果. 现代诊断与治疗. 2022(08): 1254-1256 .

Other cited types(0)

Get Citation

PDF

XML

Article views (40) PDF downloads (4) Cited by(5)

Turn off MathJax

Article Contents

Abstract

References

Establishment of a risk prediction model for catheter-associated urinary tract infection in elderly critically ill patients