중규모 종합병원 대상 카바페넴 내성 장내세균속균종(Carbapenem-resistant Enterobacteriaceae) 획득위험 예측모형의 외적타당도 평가.
Purpose: This study was aimed to evaluate the external validity of a carbapenem-resistant Enterobacteriaceae (CRE) acquisition risk prediction model (the CREP-model) in a medium-sized hospital. Methods: This retrospective cohort study included 613 patients (CRE group: 69, no-CRE group: 544) admitted...
| Publicado en: | Journal of Korean Academy of Nursing Vol. 50; no. 4; pp. 621 - 631 |
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| Autores principales: | , |
| Formato: | research tables/charts Journal Article |
| Publicado: |
Korean Society of Nursing Science
Aug2020
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=146125634&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 146125634 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 20053673 ATS7 jtl: Journal of Korean Academy of Nursing issn: 20053673 maglogo: N pubinfo: dt: Aug2020 vid: 50 iid: 4 pid: 42744 pub: Korean Society of Nursing Science place: , <Blank> artinfo: ui: 146125634 146125634 146125634 10.4040/jkan.20137 146125634 ppf: 621 ppct: 10 formats: fmt: @attributes: type: P tig: atl: 중규모 종합병원 대상 카바페넴 내성 장내세균속균종(Carbapenem-resistant Enterobacteriaceae) 획득위험 예측모형의 외적타당도 평가. aug: au: 서수민 정인숙 affil: 동의의료원 감염관리실 sug: subj: Enterobacteriaceae Infections Risk Factors Cross Infection Risk Factors Risk Assessment Carbapenem-Resistant Enterobacteriaceae Prediction Models Evaluation Models, Statistical Evaluation Human South Korea Prospective Studies Retrospective Design Record Review Inpatients Intensive Care Units APACHE (Acute Physiology and Chronic Health Evaluation) Clinical Assessment Tools Descriptive Statistics Confidence Intervals Sensitivity and Specificity Validation Studies Calibration Age Factors Drug Resistance, Multiple ab: Purpose: This study was aimed to evaluate the external validity of a carbapenem-resistant Enterobacteriaceae (CRE) acquisition risk prediction model (the CREP-model) in a medium-sized hospital. Methods: This retrospective cohort study included 613 patients (CRE group: 69, no-CRE group: 544) admitted to the intensive care units of a 453-beds secondary referral general hospital from March 1, 2017 to September 30, 2019 in South Korea. The performance of the CREP-model was analyzed with calibration, discrimination, and clinical usefulness. Results: The results showed that those higher in age had lower presence of multidrug resistant organisms (MDROs), cephalosporin use ≥ 15 days, Acute Physiology and Chronic Health Evaluation II (APACHE II) score ≥ 21 points, and lower CRE acquisition rates than those of CREP-model development subjects. The calibration-in-the-large was 0.12 (95% CI: -0.16~ 0.39), while the calibration slope was 0.87 (95% CI: 0.63~1.12), and the concordance statistic was .71 (95% CI: .63 .78). At the predicted risk of .10, the sensitivity, specificity, and correct classification rates were 43.5%, 84.2%, and 79.6%, respectively. The net true positive according to the CREP-model were 3 per 100 subjects. After adjusting the predictors' cutting points, the concordance statistic increased to .84 (95% CI: .79~.89), and the sensitivity and net true positive was improved to 75.4%. and 6 per 100 subjects, respectively. Conclusion: The CREP-model's discrimination and clinical usefulness are low in a medium sized general hospital but are improved after adjusting for the predictors. Therefore, we suggest that institutions should only use the CREP-model after assessing the distribution of the predictors and adjusting their cutting points. pubtype: Academic Journal doctype: research tables/charts Journal Article ougenre: Article language: Korean refInfo: holdings: @attributes: islocal: N |
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