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. 2017 Nov 21;7(1):15933.
doi: 10.1038/s41598-017-15765-z.

Predicting nosocomial lower respiratory tract infections by a risk index based system

Yong Chen  1 , Xue Shan  2 , Jingya Zhao  1 , Xuelin Han  1 , Shuguang Tian  1 , Fangyan Chen  1 , Xueting Su  1 , Yansong Sun  1 , Liuyu Huang  1 , Hajo Grundmann  3   4 , Hongyuan Wang  5 , Li Han  6
Affiliations

Predicting nosocomial lower respiratory tract infections by a risk index based system

Yong Chen et al. Sci Rep. .

Abstract

Although belonging to one of the most common type of nosocomial infection, there was currently no simple prediction model for lower respiratory tract infections (LRTIs). This study aims to develop a risk index based system for predicting nosocomial LRTIs based on data from a large point-prevalence survey. Among the 49328 patients included, the prevalence of nosocomial LRTIs was 1.70% (95% confidence interval [CI], 1.64% to 1.76%). The areas under the receiver operating characteristic (ROC) curve for logistic regression and fisher discriminant analysis were 0.907 (95% CI, 0.897 to 0.917) and 0.902 (95% CI, 0.892 to 0.912), respectively. The constructed risk index based system also displayed excellent discrimination (area under the ROC curve: 0.905 [95% CI, 0.895 to 0.915]) to identify LRTI in internal validation. Six risk levels were generated according to the risk score distribution of study population, ranging from 0 to 5, the corresponding prevalence of nosocomial LRTIs were 0.00%, 0.39%, 3.86%, 12.38%, 28.79% and 44.83%, respectively. The sensitivity and specificity of prediction were 0.87 and 0.79, respectively, when the best cut-off point of risk score was set to 14. Our study suggested that this newly constructed risk index based system might be applied to boost more rational infection control programs in clinical settings.

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Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Figure 1
Figure 1
The ROC curves for predicting nosocomial lower respiratory tract infection derived from logistic regression and fisher discriminant analysis.
Figure 2
Figure 2
The ROC curves for predicting nosocomial lower respiratory tract infections derived from internal validation and external 10-fold cross validation scheme based on logistic regression model.
Figure 3
Figure 3
The ROC curves for predicting nosocomial lower respiratory tract infections derived from logistic regression and risk index based system.
Figure 4
Figure 4
The number of patients and prevalence of nosocomial lower respiratory tract infections among patients with different risk scores.
See this image and copyright information in PMC

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