Influencing Factors of Infectious Diarrhea in Hospitalized Children and No-mogram Risk Prediction Model

MA Mengqi; YANG Yi

doi:10.3969/j.issn.1002-3429.2024.04.013

Abstract：Objective To explore the influencing factors of infectious diarrhea in hospitalized children and nomogram risk prediction model. Methods The clinical data of 996 hospitalized children from April 2020 to April 2023 were retrospectively collected. According to occurrence of infectious diarrhea during hospitalization, the patients were divided into a occurrence group (n =72) and a non-occurrence group (n = 924). The incidence of infective diarrhea in children was investigated, and the influencing factors of infective diarrhea in children were analyzed by univariate, Lasso regression and multivariate Logistic regression equations. R language was used to draw a nomogram model to predict the risk of infective diarrhea in hospitalized children, and receiver operating characteristic (ROC) curve was used to evaluate the predictive performance of the nomogram model. Results Of the 996 children, 72 had infectious diarrhea during hospitalization, and the incidence rate was 7. 23％, mainly virus infection (n =48). Multivariate Logistic regression analysis showed that age < 3 years, body mass index (BMI) ≤18. 4 kg/ m2 , no washing hands before and after using the toilet, no daily ventilation and disinfection in wards, intestinal flora disturbance, secreted immunoglobulin A (sIgA) ≤7. 27 μg/ mL, and CD4 + / CD8 + ≤1. 55 were the independent risk factors for infectious diarrhea in hospitalized children. The duration of hospitalization < 3 d and interleukin-17 (IL-17)≤11. 74 pg/ mL were the protective factors for infective diarrhea in hospitalized children (P <0. 01). The consistency index of the histogram was 0. 858, and the area under the curve of this nomogram model in predicting the risk of infective diarrhea in hospitalized children was 0. 858 (95％CI: 0. 814, 0. 903), the sensitivity was 68. 74％, and the specificity was 86.24％. Conclusion Viral infection is the main cause of infective diarrhea in children during hospitalization. Age, BMI, hand-washing before and after meals, length of hospital stay, daily ventilation and disinfection in wards, intestinal flora disturbance, sIgA, IL-17 and CD4 + / CD8 + levels are the influencing factors for the occurrence of infective diarrhea in hospitalized children, and clinical countermeasures can be formulated accordingly. It is necessary to strengthen the management of nosocomial infection and reduce the risk of infectious diarrhea in hospitalized children.