Construction of risk nomogram model of oral mucosal pressure injury in patients with tracheal intubation in ICU
Wang Zhiwei, He Xiaoyan, Tao Zhenzhen, Jiang Yangyang, Qi Jinfang, Li Zhengang, Dong Zhenghui
Published 2024-05-06
Cite as Chin J Mod Nurs, 2024, 30(13): 1764-1770. DOI: 10.3760/cma.j.cn115682-20230806-00391
Abstract
ObjectiveTo explore the risk factors of oral-mucosal pressure injury (OMPI) in patients with tracheal intubation in ICU and to establish a nomogram model.
MethodsUsing the convenient sampling method, a total of 640 patients with oral tracheal intubation admitted to ICU of the First Affiliated Hospital of Xinjiang Medical University from January to May 2023 were selected as the research objects. They were divided into the occurrence group (n=286) and the non-occurrence group (n=354) according to whether OMPI occurred or not. Binomial Logistic regression analysis was used to explore the risk factors for OMPI in patients with tracheal intubation in ICU. A risk nomogram model was created based on independent risk factors, and internal verification was conducted by Bootstrap repeated sampling method.
ResultsOMPI occurred in 286 of 640 ICU patients with tracheal intubation. Binomial Logistic regression analysis showed that high APACHEⅡ score, modified Beck oral score greater than or equal to 11 points, use of sedative drugs, prone ventilation, long retention time of tracheal catheter, low oxygenation index less than 200 mmHg (1 mmHg=0.133 kPa) and tracheal catheter fixation frequency of 1 time /24 h were the risk factors for OMPI in patients with tracheal intubation in ICU (P<0.05). A risk nomogram model for OMPI in patients with tracheal intubation in ICU was established based on independent risk factors. The results showed that the predictive performance (area under the receiver operating characteristic curve of subjects was 0.918, 95% confidence interval was 0.897 to 0.938) and calibration (χ2 value of 4.647, P=0.795) of the risk nomogram model for OMPI in patients with tracheal intubation in ICU were good. When the threshold probability was 0 to 1, the decision curve showed that the model had good clinical effectiveness.
ConclusionsThe OMPI risk nomogram model of tracheal intubation patients in ICU established in this study has good calibration and differentiation, which can be used as an effective tool for screening high-risk patients.
Key words:
Intensive Care Unit; Tracheal intubation; Oral mucosa; Pressure injury; Nomograph
Contributor Information
Wang Zhiwei
School of Nursing, Xinjiang Medical University, Urumqi 830011, China
He Xiaoyan
Second Department of Oncology, the Fifth People's Hospital of Qinghai Province, Xining 810007, China
Tao Zhenzhen
School of Nursing, Xinjiang Medical University, Urumqi 830011, China
Jiang Yangyang
School of Nursing, Xinjiang Medical University, Urumqi 830011, China
Qi Jinfang
Nursing Department, the Sixth Affiliated Hospital of Xinjiang Medical University, Urumqi 830063, China
Li Zhengang
Department of Critical Care Medicine, the First Affiliated Hospital of Xinjiang Medical University, Urumqi 830011, China
Dong Zhenghui
Nursing Department, the Sixth Affiliated Hospital of Xinjiang Medical University, Urumqi 830063, China
