Chinese General Practice ›› 2023, Vol. 26 ›› Issue (18): 2195-2202.DOI: 10.12114/j.issn.1007-9572.2022.0796
• Original Research • Previous Articles Next Articles
Received:
2022-08-14
Revised:
2022-12-28
Published:
2023-06-20
Online:
2023-02-23
Contact:
JIANG Qixia
通讯作者:
蒋琪霞
作者简介:
基金资助:
Add to citation manager EndNote|Ris|BibTeX
URL: https://www.chinagp.net/EN/10.12114/j.issn.1007-9572.2022.0796
特征因素 | 例数 | PI组(n=1 010) | 无PI组(n=59 545) | χ2值 | P值 |
---|---|---|---|---|---|
年龄(岁) | 778.800 | <0.001 | |||
18~49 | 21 146 | 173(17.13) | 20 973(35.22) | ||
50~59 | 12 131 | 109(10.79) | 12 022(20.19) | ||
60~69 | 13 470 | 192(19.01) | 13 278(22.30) | ||
70~79 | 8 610 | 225(22.28) | 8 385(14.08) | ||
≥80 | 5 198 | 311(30.79) | 4 887(8.21) | ||
性别 | 73.403 | <0.001 | |||
男 | 32 518 | 677(67.00) | 31 841(53.47) | ||
女 | 28 037 | 333(33.00) | 27 704(46.53) | ||
血清白蛋白(g/L) | 1 241.000 | <0.001 | |||
<35 | 17 338 | 705(69.80) | 16 633(27.93) | ||
≥35 | 43 217 | 305(30.20) | 42 912(72.07) | ||
血红蛋白(g/L) | 488.200 | <0.001 | |||
<120 | 23 870 | 761(75.35) | 23 109(38.81) | ||
≥120 | 36 685 | 249(24.65) | 36 436(61.19) | ||
失禁类型 | 302.300 | <0.001 | |||
无 | 58 642 | 687(68.02) | 57 955(97.33) | ||
尿失禁 | 802 | 98(9.70) | 704(1.18) | ||
粪失禁 | 199 | 52(5.15) | 147(0.25) | ||
粪尿双失禁 | 912 | 173(17.13) | 739(1.24) | ||
失禁频率(次/d) | 276.900 | <0.001 | |||
无 | 58 642 | 687(68.02) | 57 955(97.33) | ||
<3 | 658 | 101(10.00) | 557(0.93) | ||
3~6 | 566 | 96(9.50) | 470(0.79) | ||
>6 | 689 | 126(12.48) | 563(0.95) | ||
失禁持续时间(月) | 285.500 | <0.001 | |||
无 | 58 642 | 687(68.02) | 57 955(97.33) | ||
<3 | 1 096 | 159(15.74) | 937(1.57) | ||
3~12 | 322 | 63(6.24) | 259(0.44) | ||
>12 | 495 | 101(10.00) | 394(0.66) | ||
卧床 | 2 680.000 | <0.001 | |||
是 | 14 800 | 948(93.86) | 13 852(23.26) | ||
否 | 45 755 | 62(6.14) | 45 693(76.74) | ||
Braden量表总分(分) | 7 944.000 | <0.001 | |||
≤11 | 1 974 | 458(45.35) | 1 516(2.55) | ||
12~14 | 3 123 | 330(32.67) | 2 793(4.69) | ||
15~16 | 3 821 | 143(14.16) | 3 678(6.18) | ||
17~18 | 4 409 | 53(5.25) | 4 356(7.31) | ||
≥19 | 47 228 | 26(2.57) | 47 202(79.27) |
Table 1 Comparison of general situation between adult inpatients with and without pressure injuries
特征因素 | 例数 | PI组(n=1 010) | 无PI组(n=59 545) | χ2值 | P值 |
---|---|---|---|---|---|
年龄(岁) | 778.800 | <0.001 | |||
18~49 | 21 146 | 173(17.13) | 20 973(35.22) | ||
50~59 | 12 131 | 109(10.79) | 12 022(20.19) | ||
60~69 | 13 470 | 192(19.01) | 13 278(22.30) | ||
70~79 | 8 610 | 225(22.28) | 8 385(14.08) | ||
≥80 | 5 198 | 311(30.79) | 4 887(8.21) | ||
性别 | 73.403 | <0.001 | |||
男 | 32 518 | 677(67.00) | 31 841(53.47) | ||
女 | 28 037 | 333(33.00) | 27 704(46.53) | ||
血清白蛋白(g/L) | 1 241.000 | <0.001 | |||
<35 | 17 338 | 705(69.80) | 16 633(27.93) | ||
≥35 | 43 217 | 305(30.20) | 42 912(72.07) | ||
血红蛋白(g/L) | 488.200 | <0.001 | |||
<120 | 23 870 | 761(75.35) | 23 109(38.81) | ||
≥120 | 36 685 | 249(24.65) | 36 436(61.19) | ||
失禁类型 | 302.300 | <0.001 | |||
无 | 58 642 | 687(68.02) | 57 955(97.33) | ||
尿失禁 | 802 | 98(9.70) | 704(1.18) | ||
粪失禁 | 199 | 52(5.15) | 147(0.25) | ||
粪尿双失禁 | 912 | 173(17.13) | 739(1.24) | ||
失禁频率(次/d) | 276.900 | <0.001 | |||
无 | 58 642 | 687(68.02) | 57 955(97.33) | ||
<3 | 658 | 101(10.00) | 557(0.93) | ||
3~6 | 566 | 96(9.50) | 470(0.79) | ||
>6 | 689 | 126(12.48) | 563(0.95) | ||
失禁持续时间(月) | 285.500 | <0.001 | |||
无 | 58 642 | 687(68.02) | 57 955(97.33) | ||
<3 | 1 096 | 159(15.74) | 937(1.57) | ||
3~12 | 322 | 63(6.24) | 259(0.44) | ||
>12 | 495 | 101(10.00) | 394(0.66) | ||
卧床 | 2 680.000 | <0.001 | |||
是 | 14 800 | 948(93.86) | 13 852(23.26) | ||
否 | 45 755 | 62(6.14) | 45 693(76.74) | ||
Braden量表总分(分) | 7 944.000 | <0.001 | |||
≤11 | 1 974 | 458(45.35) | 1 516(2.55) | ||
12~14 | 3 123 | 330(32.67) | 2 793(4.69) | ||
15~16 | 3 821 | 143(14.16) | 3 678(6.18) | ||
17~18 | 4 409 | 53(5.25) | 4 356(7.31) | ||
≥19 | 47 228 | 26(2.57) | 47 202(79.27) |
影响因素 | β | SE | Wald χ2值 | P值 | OR(95%CI) |
---|---|---|---|---|---|
年龄(岁) | — | — | 24.376 | <0.001 | — |
18~49 | — | — | — | — | 1.00 |
50~59 | -0.014 | 0.134 | 0.011 | 0.915 | 0.99(0.76,1.29) |
60~69 | 0.320 | 0.116 | 7.642 | 0.005 | 1.38(1.10,1.73) |
70~79 | 0.350 | 0.114 | 9.545 | 0.002 | 1.41(1.13,1.77) |
≥80 | 0.435 | 0.109 | 15.996 | <0.001 | 1.55(1.25,1.91) |
性别 | 0.326 | 0.076 | 18.426 | <0.001 | 1.38(1.19,1.61) |
血清白蛋白 | 0.754 | 0.081 | 86.167 | <0.001 | 2.14(1.83,2.51) |
血红蛋白 | 0.419 | 0.086 | 23.644 | <0.001 | 1.52(1.29,1.80) |
失禁类型 | — | — | 20.995 | <0.001 | — |
无 | — | — | — | — | 1.00 |
尿失禁 | -0.067 | 0.110 | 0.374 | 0.436 | 0.89(0.66,1.19) |
粪失禁 | -0.144 | 0.148 | 0.951 | 0.329 | 0.87(0.65,1.16) |
粪尿双失禁 | 0.762 | 0.202 | 14.231 | <0.001 | 2.41(1.61,3.63) |
卧床 | 0.795 | 0.163 | 23.831 | <0.001 | 2.22(1.61,3.05) |
Braden量表总分(分) | — | — | 599.499 | <0.001 | — |
≥19 | — | — | — | — | 1.00 |
≤11 | 5.124 | 0.257 | 398.237 | <0.001 | 167.76(101.43,277.48) |
12~14 | 4.330 | 0.253 | 293.925 | <0.001 | 76.40(46.57,125.33) |
15~16 | 3.411 | 0.256 | 178.089 | <0.001 | 30.30(18.36,50.00) |
17~18 | 2.492 | 0.269 | 85.686 | <0.001 | 12.10(7.14,20.50) |
Table 2 Logistics regression analysis of the factors associated with pressure injuries in adult inpatients
影响因素 | β | SE | Wald χ2值 | P值 | OR(95%CI) |
---|---|---|---|---|---|
年龄(岁) | — | — | 24.376 | <0.001 | — |
18~49 | — | — | — | — | 1.00 |
50~59 | -0.014 | 0.134 | 0.011 | 0.915 | 0.99(0.76,1.29) |
60~69 | 0.320 | 0.116 | 7.642 | 0.005 | 1.38(1.10,1.73) |
70~79 | 0.350 | 0.114 | 9.545 | 0.002 | 1.41(1.13,1.77) |
≥80 | 0.435 | 0.109 | 15.996 | <0.001 | 1.55(1.25,1.91) |
性别 | 0.326 | 0.076 | 18.426 | <0.001 | 1.38(1.19,1.61) |
血清白蛋白 | 0.754 | 0.081 | 86.167 | <0.001 | 2.14(1.83,2.51) |
血红蛋白 | 0.419 | 0.086 | 23.644 | <0.001 | 1.52(1.29,1.80) |
失禁类型 | — | — | 20.995 | <0.001 | — |
无 | — | — | — | — | 1.00 |
尿失禁 | -0.067 | 0.110 | 0.374 | 0.436 | 0.89(0.66,1.19) |
粪失禁 | -0.144 | 0.148 | 0.951 | 0.329 | 0.87(0.65,1.16) |
粪尿双失禁 | 0.762 | 0.202 | 14.231 | <0.001 | 2.41(1.61,3.63) |
卧床 | 0.795 | 0.163 | 23.831 | <0.001 | 2.22(1.61,3.05) |
Braden量表总分(分) | — | — | 599.499 | <0.001 | — |
≥19 | — | — | — | — | 1.00 |
≤11 | 5.124 | 0.257 | 398.237 | <0.001 | 167.76(101.43,277.48) |
12~14 | 4.330 | 0.253 | 293.925 | <0.001 | 76.40(46.57,125.33) |
15~16 | 3.411 | 0.256 | 178.089 | <0.001 | 30.30(18.36,50.00) |
17~18 | 2.492 | 0.269 | 85.686 | <0.001 | 12.10(7.14,20.50) |
患者特征 | AUC | 95%CI | 灵敏度 | 特异度 | 约登指数 | 最佳界值(分) |
---|---|---|---|---|---|---|
科室 | ||||||
ICU | 0.78 | (0.76,0.81) | 0.86 | 0.61 | 0.47 | 13.50 |
老年科 | 0.88 | (0.85,0.91) | 0.83 | 0.80 | 0.63 | 13.50 |
神经内科 | 0.93 | (0.91,0.94) | 0.96 | 0.81 | 0.77 | 16.50 |
内科 | 0.97 | (0.97,0.98) | 0.97 | 0.91 | 0.88 | 17.50 |
外科 | 0.93 | (0.91,0.94) | 0.93 | 0.79 | 0.72 | 18.50 |
其他 | — | — | — | — | — | — |
年龄(岁) | ||||||
18~49 | 0.95 | (0.94,0.97) | 0.93 | 0.85 | 0.78 | 18.50 |
50~59 | 0.96 | (0.95,0.97) | 0.93 | 0.90 | 0.83 | 16.50 |
60~69 | 0.95 | (0.94,0.96) | 0.95 | 0.85 | 0.80 | 17.50 |
70~79 | 0.93 | (0.92,0.94) | 0.92 | 0.82 | 0.74 | 16.50 |
≥80 | 0.89 | (0.88,0.91) | 0.90 | 0.72 | 0.62 | 15.50 |
Table 3 The predictive value and optimal cutoff value of the Braden Scale for pressure injuries in adult inpatients in different departments and age groups
患者特征 | AUC | 95%CI | 灵敏度 | 特异度 | 约登指数 | 最佳界值(分) |
---|---|---|---|---|---|---|
科室 | ||||||
ICU | 0.78 | (0.76,0.81) | 0.86 | 0.61 | 0.47 | 13.50 |
老年科 | 0.88 | (0.85,0.91) | 0.83 | 0.80 | 0.63 | 13.50 |
神经内科 | 0.93 | (0.91,0.94) | 0.96 | 0.81 | 0.77 | 16.50 |
内科 | 0.97 | (0.97,0.98) | 0.97 | 0.91 | 0.88 | 17.50 |
外科 | 0.93 | (0.91,0.94) | 0.93 | 0.79 | 0.72 | 18.50 |
其他 | — | — | — | — | — | — |
年龄(岁) | ||||||
18~49 | 0.95 | (0.94,0.97) | 0.93 | 0.85 | 0.78 | 18.50 |
50~59 | 0.96 | (0.95,0.97) | 0.93 | 0.90 | 0.83 | 16.50 |
60~69 | 0.95 | (0.94,0.96) | 0.95 | 0.85 | 0.80 | 17.50 |
70~79 | 0.93 | (0.92,0.94) | 0.92 | 0.82 | 0.74 | 16.50 |
≥80 | 0.89 | (0.88,0.91) | 0.90 | 0.72 | 0.62 | 15.50 |
Braden量表分量表 | AUC | 95%CI | 灵敏度 | 特异度 | 约登指数 | 最佳界值(分) |
---|---|---|---|---|---|---|
感知能力 | 0.79 | (0.76,0.81) | 0.82 | 0.68 | 0.50 | 3.50 |
潮湿度 | 0.79 | (0.76,0.81) | 0.83 | 0.70 | 0.53 | 3.50 |
活动能力 | 0.80 | (0.78,0.81) | 0.89 | 0.65 | 0.54 | 1.50 |
移动能力 | 0.84 | (0.82,0.86) | 0.81 | 0.75 | 0.56 | 2.50 |
营养 | 0.80 | (0.78,0.82) | 0.85 | 0.67 | 0.52 | 2.50 |
摩擦和剪切力 | 0.87 | (0.85,0.88) | 0.65 | 0.91 | 0.56 | 1.50 |
Table 4 Predictive values and optimal cut-off values of six subscales of the Braden Scale for pressure injuries in adult inpatients
Braden量表分量表 | AUC | 95%CI | 灵敏度 | 特异度 | 约登指数 | 最佳界值(分) |
---|---|---|---|---|---|---|
感知能力 | 0.79 | (0.76,0.81) | 0.82 | 0.68 | 0.50 | 3.50 |
潮湿度 | 0.79 | (0.76,0.81) | 0.83 | 0.70 | 0.53 | 3.50 |
活动能力 | 0.80 | (0.78,0.81) | 0.89 | 0.65 | 0.54 | 1.50 |
移动能力 | 0.84 | (0.82,0.86) | 0.81 | 0.75 | 0.56 | 2.50 |
营养 | 0.80 | (0.78,0.82) | 0.85 | 0.67 | 0.52 | 2.50 |
摩擦和剪切力 | 0.87 | (0.85,0.88) | 0.65 | 0.91 | 0.56 | 1.50 |
[1] |
European Pressure Ulcer Advisory Panel,National Pressure Injury Advisory Panel,Pan Pacific Pressure Injury Alliance. Prevention and treatment of pressure Ulcers/Injuries:clinical practice guideline. The International guideline. 3rd Edition. Emily Haesler (ED) [EB/OL]. (2019-11-12)[2022-10-19].
|
[2] |
|
[3] |
|
[4] |
|
[5] |
国家卫生计生委医院管理研究所护理中心护理质量指标研发小组. 护理敏感质量指标实用手册:2016版[M]. 北京:人民卫生出版社,2016:115-130.
|
[6] |
蒋琪霞,王桂玲. 压力性损伤预防敏感结局指标的监控方法进展[J]. 医学研究生学报,2019,32(1):104-108. DOI:10.16571/j.cnki.1008-8199.2019.01.023.
|
[7] |
蒋琪霞,苗素琴,陈文芳,等. 手术获得性压力性损伤流行特征和危险评估新进展[J]. 医学研究生学报,2019,32(8):882-885. DOI:10.16571/j.cnki.1008-8199.2019.08.019.
|
[8] |
|
[9] |
|
[10] |
马妍,张玉勤,张春琰. 早期预警评分联合Braden评分对急诊老年危重症病人预后的评估效果[J]. 实用老年医学,2022,36(5):483-486. DOI:10.3969/j.issn.1003-9198.2022.05.012.
|
[11] |
张宁,李晓刚,商之涵,等. 改良早期预警评分联合Braden评分对ICU老年患者压力性损伤的预测研究[J]. 中华急危重症护理杂志,2020,1(5):394-397.
|
[12] |
|
[13] |
|
[14] |
|
[15] |
|
[16] |
|
[17] |
|
[18] |
|
[19] |
宋思平,汤雨佳,蒋琪霞,等. Braden量表预测ICU患者压疮发生风险有效性的系统评价[J]. 东南国防医药,2020,22(4):420-424. DOI:10.3969/j.issn.1672-271X.2020.04.020.
|
[20] |
|
[21] |
|
[22] |
|
[23] |
|
[24] |
|
[25] |
俞惠,蒋琪霞. 压疮预防现况调研工具的构建及信效度检验[J]. 医学研究生学报,2018,31(1):65-69. DOI:10.16571/j.cnki.1008-8199.2018.01.014.
|
[26] |
蒋琪霞,王祖晶,康宙清,等. 52所医院参研护士识别老年皮肤损伤知识现况及培训效果[J]. 医学研究生学报,2022,35(6):640-644. DOI:10.16571/j.cnki.1008-8199.2022.06.013.
|
[27] |
蒋琪霞,解怡洁,白育瑄,等. 中国老年人皮肤损伤患病率及其流行特征的多中心横断面研究[J]. 中国全科医学,2022,25(21):2569-2576. DOI:10.12114/j.issn.1007-9572.2022.0258.
|
[28] |
蒋琪霞,白育瑄,唐永利,等. 老年皮肤干燥症现患率及流行特征的多中心横断面研究[J]. 医学研究生学报,2021,34(11):1182-1187. DOI:10.16571/j.cnki.1008-8199.2021.11.012.
|
[29] |
陈峰,夏结来. 临床试验统计学[M]. 北京:人民卫生出版社,2018:358-376.
|
[30] |
|
[31] |
|
[32] |
|
[1] | GUO Yunting, HOU Xiaomin, BAI Jianying, CHANG Mingyang, ZHAO Xu, SUN Lin, ZHENG Zhifa, SHI Yiwei, QIN Xiaojiang. Prediction of Severity and Length of Hospital Stay in Patients with Group 2 Pulmonary Hypertension Based on Serum Potassium Level [J]. Chinese General Practice, 2024, 27(09): 1068-1073. |
[2] | ZENG Lingcong, ZHANG Longju, ZHOU Ling, ZHANG Wei, DAI Meng, HUANG Yin, HUANG Yi. Analysis of the Predictive Value of 4-level Clinical Pretest Probability Score in Elderly Patients with Acute Pulmonary Embolism [J]. Chinese General Practice, 2024, 27(09): 1062-1067. |
[3] | LIN Lingjun, GUO Jun, WANG Junwei, GAO Yang, CHEN Huiying, WAN Yongli. A Systematic Review of Risk Prediction Models for Diabetic Foot Development [J]. Chinese General Practice, 2024, 27(03): 357-363. |
[4] | WANG Qiushi, LI Hongwei. The Predictive Value of CHA2DS2-VASc Score on Major Adverse Cardiovascular Events in Patients with Three Vessels or Left Main Diseases of Coronary Heart Disease [J]. Chinese General Practice, 2023, 26(33): 4130-4136. |
[5] | CHEN Yijia, QI Shengxiang, DU Jinling, WANG Chenchen, ZHOU Hairong, YE Qing, QIN Zhenzhen, SU Jian, WU Ming, HONG Xin. Predictive Value of Cardiometabolic Index for Metabolically Obese Phenotype in Normal Weight Population [J]. Chinese General Practice, 2023, 26(14): 1716-1725. |
[6] | CHEN Ying, WANG Zihan, XUE Chongxiang, TAO Shiyi, SUN Ziyi, HUANG Li. The Predictive Value of Ankle Brachial Index, Brachial-ankle Pulse Wave Velocity, Flow-mediated Dilation Combined with Apolipoprotein B to Apolipoprotein A-1 Ration on Coronary Heart Disease with Blood Stasis Syndrome in Middle-aged and Young Adults [J]. Chinese General Practice, 2023, 26(14): 1726-1732. |
[7] | TAO Lu, ZENG Kai, NIE Zuoting, ZONG Qianxing, CHEN Long, WU Yan, YANG Rumei. Mediating Effect of Frailty on the Association between Apathy and Fall Risk in Older Adults in the Community [J]. Chinese General Practice, 2023, 26(12): 1444-1449. |
[8] | YU Jie, LI Hongling, ZHAO Gang, LI Jingui. Effect of Circling Moxibustion on the Ultrastructure of Wound Tissue in Rats with Pressure Injury [J]. Chinese General Practice, 2023, 26(11): 1375-1381. |
[9] | HU Huachao, CHEN Xianya, XIE Siyuan, XIA Zhen, XIAO Hua. Clinical Characteristics and Treatment of Atrial Fibrillation and Heart Failure: a Multicenter Survey [J]. Chinese General Practice, 2023, 26(05): 541-549. |
[10] | TANG Zhaoyun, HE Yang, CHEN Cong, YANG Xiaodan, WU Xinhua, LIU Hong. Risk Assessment of Ischemic Cardiovascular Disease in Rural Naxi Population in Low-to-high Altitudes [J]. Chinese General Practice, 2022, 25(36): 4522-4527. |
[11] | Tianxiao FENG, Kangjian LI, Dawei YU, Hailong HE, Juntao ZHANG, Minshan FENG, Ping WANG. Quality Evaluation of Randomized Controlled Trials on the Treatment of Cervical Spondylosis with TCM Manipulation [J]. Chinese General Practice, 2022, 25(29): 3664-3671. |
[12] | Junmin SONG, Peng YANG, Gang LIU, Zhiguang ZHAO, Danting WAN, Hairui WANG, Ziqian XU, Donghai WANG, Junjie XIA. The Self-rated Fall Risk Questionnaire and Modified Falls Efficacy Scale in Assessing the Fall Risk in Community-dwelling Older Chinese Adults: a Comparative Study [J]. Chinese General Practice, 2022, 25(25): 3097-3100. |
[13] | Qin LI, Xin TAN, Wenxi JIANG, Meng YUAN, Hui NI, Yuan WANG, Jie DU. Predictive Model for Long-term Major Adverse Cardiovascular Events in Patients with Acute Myocardial Infarction Undergoing Percutaneous Coronary Intervention [J]. Chinese General Practice, 2022, 25(24): 2965-2974. |
[14] | Ke QIN, Tonglin LI, Shuai GONG, Meifang JIANG. Changes and Response Predictive Values of Serum miR-210 and miR-181a in Stable Chronic Obstructive Pulmonary Disease Patients Treated with Glucocorticoid Therapy [J]. Chinese General Practice, 2022, 25(24): 3013-3017. |
[15] | Qixia JIANG, Yijie XIE, Yuxuan BAI, Haixia FENG, Qianzhu CHEN, Defeng CHEN, Yanhong GAO, Xuehong WANG, Yanshuang ZHANG, Xiaohong PAN, Yingchun PAN, Jing ZHAO, Jinmei YU, Huijuan SUO, Yanyan HONG, Yingying ZHAN, Dongmei LI, Haiyan LIU, Xia LI, Dan KUANG, Qing PENG, Jing WANG, Ping YU, Rui CHEN, Yunmin CAI, Ling HUANG, Zujing WANG, Guangyang WANG, Jingping HAO, Dongmei ZHU. Prevalence and Epidemiologic Features of Skin Injuries in Chinese Older Adults: a Multicenter Cross-sectional Study [J]. Chinese General Practice, 2022, 25(21): 2569-2576. |
Viewed | ||||||
Full text |
|
|||||
Abstract |
|
|||||