Construction and validation of prediction model of intracranial infection after external ventricular drainage

Xue YANG; Tunan CHEN; Zhi CHEN; Chao ZHANG; Xueying ZHANG; Li WEI; Miao LIU; Jishu XIAN

doi:10.16016/j.2097-0927.202207086

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Construction and validation of prediction model of intracranial infection after external ventricular drainage

Clinical Medicine | 更新时间：2026-01-09

- Construction and validation of prediction model of intracranial infection after external ventricular drainage
- Journal of Army Medical University Vol. 45, Issue 3, Pages: 265-271(2023)
- 作者机构：
  
  400038 重庆，陆军军医大学(第三军医大学)第一附属医院神经外科
- 作者简介：
- 基金信息：
- DOI：10.16016/j.2097-0927.202207086
  CLC： R473.6;R619.3;R651.11
- Received：12 July 2022，
  
  Revised：2022-08-01，
  
  Published：15 February 2023
- 稿件说明：
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Xue YANG, Tunan CHEN, Zhi CHEN, et al. Construction and validation of prediction model of intracranial infection after external ventricular drainage[J]. Journal of Army Medical University, 2023, 45(3): 265-271.
DOI：

Xue YANG, Tunan CHEN, Zhi CHEN, et al. Construction and validation of prediction model of intracranial infection after external ventricular drainage[J]. Journal of Army Medical University, 2023, 45(3): 265-271. DOI： 10.16016/j.2097-0927.202207086.

摘要

目的

探讨脑室外引流术后患者颅内感染的影响因素，构建并验证风险预测模型。

方法

采用回顾性资料分析法，选取2010-2018年在本院神经外科行脑室外引流(external ventricular drainage，EVD)手术治疗的患者757例(建模组)，根据术后是否发生颅内感染分为颅内感染组(

=79)和非颅内感染组(

=678)，对两组资料进行对比，利用单因素分析和Logistic回归分析探讨脑室外引流术后患者颅内感染的影响因素，建立风险预测模型并绘制列线图。另选择2019-2020年本院148例EVD患者作为验证组，其中术后颅内感染组8例，非颅内感染组140例；利用ROC曲线下面积和Hosmer-Lemeshow检验来评估模型预测效果。

结果

低蛋白血症、合并腰池引流、脑室外引流时间＞7 d、合并肺部感染、合并气管切开、开放性颅脑外伤、合并手术切口感染、合并菌血症/脓毒血症是脑室外引流术后患者颅内感染的影响因素。预测模型验证结果显示，建模组术后发生颅内感染风险的ROC曲线下面积为0.923(

0.01)，验证组术后发生颅内感染风险的ROC曲线下面积为0.920(

0.01)。建模组和验证组Hosmer-Lemeshow检验的

值分别为0.450和0.877。

结论

脑室外引流术后导致颅内感染的高危影响因素有8项，构建的模型可以有效预测脑室外引流术后患者颅内感染的发生。

Abstract

Objective

To explore the influencing factors of intracranial infection in patients after ventricular drainage

and to build and verify the established risk prediction model.

Methods

A retrospective analysis was carried out on 757 patients who underwent external ventricular drainage (EVD) in our department from January 2010 to December 2018. According to the occurrence of postoperative intracranial infection

they were divided into intracranial infection group (

=79) and non-intracranial infection group (

=678). Their clinical data were collected and compared. Univariate analysis and multivariate logistic regression analysis were used to explore the influencing factors of intracranial infection after ventricular drainage. A risk prediction model was established and anomogram was drawn. Another 148 patients with EVD in our hospital from 2019 to 2020 were selected as the validation group

including 8 patients with intracranial infection after surgery and 140 patients without. The area

under receiver operating characteristic (ROC) curve and Hosmer-Lemeshow test were employed to evaluate the prediction efficacy of the model.

Results

Hypoproteinemia

lumbar cisternae drainage

EVD time

7 d

pulmonary infection

tracheotomy

open craniocerebral trauma

surgical incision infection

and complicated with bacteremia/sepsis were influencing factors of intracranial infection after EVD. The validation results for the prediction model showed that the area under ROC curve for the risk of postoperative intracranial infection was 0.923 in the modeling group and 0.920 in the verification sample (

0.01). As to the Hosmer-Lemeshow test

the

value was 0.450 in the modeling patients and 0.877 in those from the verification group.

Conclusion

There are 8 high-risk factors for incidence of intracranial infection in patients after EVD. Our established model can effectively predict the occurrence of intracranial infection in these patients.

关键词

Keywords

references

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