Analysis of influencing factors and establishment of predictive models for neonatal respiratory distress syndrome with ventilator-associated pneumonia
WU Jie
LIU Yanfeng
Abstract：Objective To explore the influencing factors and establishment of predictive models for neonatal respiratory distress syndrome(NRDS)with ventilator-associated pneumonia(VAP).Methods A retrospective analysis was conducted on the clinical data of 110 cases of NRDS admitted to our hospital from December 2020 to December 2022.The patients were randomly divided into a VAP group of 37 cases and a non VAP group of 73 cases based on the presence or absence of VAP.By conducting one-way ANOVA on two sets of general data,and incorporating statistically significant indicators into the binary logistic regression model analysis for assessing the related factors of VAP in children with NRDS.Results Binary logistic regression analysis showed that a duration of inspiratory fraction of oxygen(FiO2)＞0.6＞10 hours,repeated intubation times＞3 times,non-invasive ventilation time after extubation,D-dimer(D-D),interleukin-6(IL-6),interferon y(IFN-γ),IFN-γ/IL-4 were all risk factors for VAP in children with NRDS;While,Neonatal Critical Illness Score(NCIS),and IL-4 were protective factors for VAP in children with NRDS(P＜0.05).In the predictive models,the overall prediction accuracy of the model was 99.1％,and the Hosmer-Lemeshow fit test showed a good goodness of fit between the fitted values and the observed values(Chi=0.112,P=0.950＞0.05).The Bootstrap method was used to perform internal validation on the model,with AUC of 0.977 and 95％CI of 0.953-1.000.The model had good accuracy and could effectively predict the incidence of VAP in children with NRDS.Conclusion The duration of FiO2＞0.6＞10 hours,repeated intubation times＞3 times,non-invasive ventilation time after extubation,D-D,IL-6,IFN-γ,IFN-γ/IL-4 are all risk factors for VAP in children with NRDS.While,NCIS score and IL-4 are protective factors.Establishing a risk prediction model based on the above related factors has good stability and predictive performance.
Keywords：neonatal respiratory distress syndromeventilator associated pneumoniainfluencing factorsrisk prediction model
Publication Date：2025-07-26
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：5( 1089-1092,1098 )