ABSTRACT
BACKGROUND@#Postoperative pneumonia (POP) is one of the most common infections following heart valve surgery (HVS) and is associated with a significant increase in morbidity, mortality, and health care costs. This study aimed to identify the major risk factors associated with the occurrence of POP following HVS and to derive and validate a clinical risk score.@*METHODS@#Adults undergoing open HVS between January 2016 and December 2019 at a single institution were enrolled in this study. Patients were randomly assigned to the derivation and validation sets at 1:1 ratio. A prediction model was developed with multivariable logistic regression analysis in the derivation set. Points were assigned to independent risk factors based on their regression coefficients.@*RESULTS@#POP occurred in 316 of the 3853 patients (8.2%). Multivariable analysis identified ten significant predictors for POP in the derivation set, including older age, smoking history, chronic obstructive pulmonary disease, diabetes mellitus, renal insufficiency, poor cardiac function, heart surgery history, longer cardiopulmonary bypass, blood transfusion, and concomitant coronary and/or aortic surgery. A 22-point risk score based on the multivariable model was then generated, demonstrating good discrimination (C-statistic: 0.81), and calibration (Hosmer-Lemeshow χ2 = 8.234, P = 0.312). The prediction rule also showed adequate discriminative power (C-statistic: 0.83) and calibration (Hosmer-Lemeshow χ2 = 5.606, P = 0.691) in the validation set. Three risk intervals were defined as low-, medium-, and high-risk groups.@*CONCLUSION@#We derived and validated a 22-point risk score for POP following HVS, which may be useful in preventive interventions and risk management.@*TRIAL REGISTRATION@#Chictr.org, ChiCTR1900028127; http://www.chictr.org.cn/showproj.aspx?proj=46932.
Subject(s)
Adult , Aged , Humans , Cardiac Surgical Procedures/adverse effects , Cardiopulmonary Bypass , Heart Valves , Pneumonia , Risk FactorsABSTRACT
Objective To investigate of mental health level and coping style in emergency nurses. Methods Investigations were conducted in 78 emergency nurses who had been m the emergency department over one year from 4 general hospitals in Huizhou using general condition questionnaire, symptom checklist 90 (SCL-90) and simple coping style questionnaire, the results underwent analysis. Results The subfactor score of SCL- 90 was significantly higher than that of Chinese norm. Emergency nurses adopted positive coping style more then conunon adillt group. The positive coping style of nurses was negatively correlated with the total score of SCL-90, somatization, interpersonal relationship, depression and anxiety factor of SCL-90. The negative coping style was positively correlated with the total score, sornatization, depression and anxiety factor of SCL-90.Conchusions Emergency nurses have poor mental health. We must adopt effective means to improve theirs mental health level.