Volume 23 Issue 9
Sep.  2025
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Article Navigation >  Chinese Journal of General Practice  > 2025  >  23(9): 1539-1543
GONG Yiwen, LIU Ying, XU Ye. Construction and validation of a logistic regression model for predicting pulmonary infection risk in stroke patients undergoing left-right contralateral C7 nerve transfer surgery[J]. Chinese Journal of General Practice, 2025, 23(9): 1539-1543. doi: 10.16766/j.cnki.issn.1674-4152.004173
Citation: GONG Yiwen, LIU Ying, XU Ye. Construction and validation of a logistic regression model for predicting pulmonary infection risk in stroke patients undergoing left-right contralateral C7 nerve transfer surgery[J]. Chinese Journal of General Practice, 2025, 23(9): 1539-1543. doi: 10.16766/j.cnki.issn.1674-4152.004173
shu

Construction and validation of a logistic regression model for predicting pulmonary infection risk in stroke patients undergoing left-right contralateral C7 nerve transfer surgery

doi: 10.16766/j.cnki.issn.1674-4152.004173

  • Department of Hand and Upper Limb Surgery, Jing' an District Central Hospital, Shanghai 200040, China

Funds:

 10000015Z155080000004

 2024HL02

  • Received Date: 2024-11-15
    Available Online: 2025-11-17
    Abstract
  •   Objective   To identify sensitive indicators for assessing pulmonary infection risk in stroke patients following left-right contralateral C7 nerve transfer surgery, and to develop and validate a risk-prediction nomogram to support clinical condition assessment and clinical decision-making.   Methods   A retrospective analysis was conducted on 294 stroke patients who underwent left-right contralateral C7 nerve transfer surgery at Jing' an District Central Hospital between March 2021 and December 2023. Patients were stratified into an infection group (n=29) and a non-infection group (n=265) based on standardized diagnostic criteria for pulmonary infection. Demographic statistical indicators, laboratory indicators and other data of the two groups were collected. LASSO and logistic regression were used to analyze the risk factors of pulmonary infection after the left-right contralateral C7 nerve transfer surgery of stroke patients. The postoperative pulmonary infection risk prediction model was established, and the ROC curve was evaluated to analyze the efficiency and verify the stability of the model.   Results   There were significant differences in age, diabetes mellitus, peak expiratory flow (PEF), FEV1/FVC, VCmax, operation time, Beck score, American Society of Anesthesiologists (ASA) grading, and preoperative EMG abnormalities between the two groups (P < 0.05). Multifactor LASSO regression analysis showed that when λ. 1se=0.040 7, 7 predictors finally fit the characteristics. Multivariate analysis identified that age >60 years old and high Beck score as independent risk factors, while PEF≥320 L/min and FEV1/FVC≥92% were protective factors (P < 0.05). The model achieved an AUC of 0.983 (95% CI: 0.968-0.998), with sensitivity and specificity of 0.931 and 0.936, respectively. Internal validation Bootstrap (B=1 000) confirmed stable predictive performance, and decision curve analysis showed clinical utility.   Conclusion   Age>60 years old and elevated Beck score are independent risk factors, whereas PEF≥320 L/min and FEV1/FVC≥92% are protective factors. The nomogram model showed excellent predictive effect on pulmonary infection, and can provide data support for clinical evaluation and decision-making.

     

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    • References(20)
  • [1]
    吴近仪, 吴敏杰, 魏鹏, 等. 早期综合康复治疗对改善中老年脑卒中偏瘫患者运动功能及日常生活能力的临床疗效观察[J]. 中华全科医学, 2022, 20(12): 2123-2126. doi: 10.16766/j.cnki.issn.1674-4152.002784

    WU J Y, WU M J, WEI P, et al. Clinical effect of early comprehensive rehabilitation therapy on improving the motor functions and activities of daily living in middle-aged and elderly stroke patients with hemiplegia[J]. Chinese Journal of General Practice, 2022, 20(12): 2123-2126. doi: 10.16766/j.cnki.issn.1674-4152.002784
    [2]
    WANG Y J, LI Z X, GU H Q, et al. China stroke statistics: an update on the 2019 report from the national center for healthcare quality management in neurological diseases, China national clinical research center for neurological diseases, the Chinese stroke association, national center for chronic and non-communicable disease control and prevention, Chinese center for disease control and prevention and institute for global neuroscience and stroke collaborations[J]. Stroke Vasc Neurol, 2022, 7(5): 415-450. doi: 10.1136/svn-2021-001374
    [3]
    马利中, 董玲婉, 朱靖, 等. 老年脑卒中患者肺部感染、深静脉血栓发生率及相关性研究[J]. 中华全科医学, 2016, 14(12): 2034-2036. doi: 10.16766/j.cnki.issn.1674-4152.2016.12.019

    MA L Z, DONG L W, ZHU J, et al. Incidence of pulmonary infection and correlation with deep venous thrombosis in elderly stroke patients[J]. Chinese Journal of General Practice, 2016, 14(12): 2034-2036. doi: 10.16766/j.cnki.issn.1674-4152.2016.12.019
    [4]
    方萍, 金平, 霍佳佳, 等. 急性脑卒中患者肺部感染风险预测模型的构建及验证[J]. 护理学杂志, 2023, 38(16): 30-33.

    FANG P, JIN P, HUO J J, et al. Construction and verification of a risk prediction model for pulmonary infection in patients with acute stroke[J]. Journal of Nursing Science, 2023, 38(16): 30-33.
    [5]
    李卫征, 刘伟, 武国良, 等. 缺血性脑卒中患者并发肺部感染的病原学特点及危险因素分析[J]. 中国病原生物学杂志, 2023, 18(11): 1320-1323, 1328.

    LI W Z, LIU W, WU G L, et al. Pathogenic characteristics and risk factors of pulmonary infection in patients with ischemic stroke[J]. Journal of Pathogen Biology, 2023, 18(11): 1320-1323, 1328.
    [6]
    WANG Y, LI Y, WANG X, et al. Diagnostic value of coagulation index and serum inflammatory cytokines in hemorrhagic stroke patients with pulmonary infection in the sequelae stage[J]. Technol Health Care, 2024, 32(3): 1383-1391. doi: 10.3233/THC-230345
    [7]
    李晨红, 姜晨黎, 王金慧, 等. 脑出血患者微创颅内血肿清除术后肺部感染的影响因素分析及预测模型构建[J]. 中国卒中杂志, 2024, 19(5): 532-538.

    LI C H, JIANG C L, WANG J H, et al. Analysis of Influencing Factors and Construction of Prediction Models for Pulmonary Infection after Minimally Invasive Intracranial Hematoma Removal in Patients with Intracerebral Hemorrhage[J]. Chinese Journal of Stroke, 2024, 19(5): 532-538.
    [8]
    中华医学会呼吸病学分会感染学组. 中国成人医院获得性肺炎与呼吸机相关性肺炎诊断和治疗指南(2018年版)[J]. 中华结核和呼吸杂志, 2018, 41(4): 255-280.

    Infectious Diseases Group, Chinese Society of Respiratory Medicine. The Guidelines for the Diagnosis and Treatment of ventilator-Associated Pneumonia in Adult Hospitals of China(2018)[J]. Chinese Journal of Tuberculosis and Respiratory Diseases, 2018, 41(4): 255-280.
    [9]
    严正村, 顾加祥, 刘宏君, 等. 神经内镜下经椎体前路健侧颈7神经移位手术治疗中枢性上肢痉挛性瘫痪的解剖学与临床应用研究[J]. 中华神经医学杂志, 2024, 23(9): 911-917.

    YAN Z C, GU J X, LIU H J, et al. Anatomical study and clinical application of neuroendoscopy assisted contralateral cervical 7 nerve transfer via prespinal route in central upper limb spastic paralysis[J]. Chinese Journal of Neuromedicine, 2024, 23(9): 911-917.
    [10]
    王翠英, 梅静, 吴家旺, 等. 精准气道护理在改善脑卒中气管切开患者肺部感染中的效果研究[J]. 安徽医学, 2023, 44(12): 1520-1524.

    WANG C Y, MEI J, WU J W, et al. Study on the Effect of Precision Airway Care in Improving Pulmonary Infection in Stroke Patients Undergoing Tracheotomy[J]. Anhui Medical Journal, 2023, 44(12): 1520-1524.
    [11]
    张贺, 梁绍钦, 杜文杰, 等. 脑出血患者气管切开并发肺部感染的预测研究[J]. 中华脑科疾病与康复杂志(电子版), 2022, 12(5): 291-297.

    ZHANG H, LIANG S Q, DU W J, et al. Prediction of pulmonary infection after tracheotomy in patients with hemorrhagic stroke[J]. Chinese Journal of Brain Diseases and Rehabilitation(Electronic Edition), 2022, 12(5): 291-297.
    [12]
    滕欣, 黄年平, 莫家鹏. IL-17单核苷酸多态性与急性脑梗死介入治疗后肺部感染的相关性[J]. 热带医学杂志, 2022, 22(10): 1376-1380.

    TENG X, HUANG N P, MO J P. Correlation between single nucleotide polymorphisms of IL-17 and lung infection after interventional therapy for acute cerebral infarction[J]. Journal of Tropical Medicine, 2022, 22(10): 1376-1380.
    [13]
    王玉珏, 王朋, 易建中. 缺血性脑梗死介入治疗后并发肺部感染危险因素分析[J]. 中华肺部疾病杂志(电子版), 2022, 15(4): 557-559.

    WANG Y J, WANG P, YI J Z. Risk factors of pulmonary infection after interventional treatment for ischemic cerebral infarction[J]. Chinese Journal of Lung Diseases(Electronic Edition), 2022, 15(4): 557-559.
    [14]
    GGER Y E, ZKENT M S, KLN M T, et al. Influencing factors of acute kidney injury following retrograde intrarenal surgery[J]. World J Urol, 2023, 41(3): 857-864. doi: 10.1007/s00345-023-04301-6
    [15]
    杨露, 魏海棠, 谢亮, 等. 吞咽功能训练联合肺康复对脑卒中后气管切开患者拔管成功率及肺部感染疗效的研究[J]. 中国康复, 2022, 37(1): 33-36.

    YANG L, WEI H T, XIE L, et al. Swallowing function training combined with pulmonary rehabilitation on the success rate of extubation and pulmonary infection in patients with tracheotomy after stroke[J]. Chinese Journal of Rehabilitation, 2022, 37(1): 33-36.
    [16]
    戴玉凤. 高血压脑出血患者微创钻孔引流术后肺部感染危险因素分析[J]. 河北医学, 2017, 23(8): 1337-1339.

    DAI Y F. Analysis of Risk Factors for Pulmonary Infection in Patients with Hypertensive Intracerebral Hemorrhage after Minimally invasive Drilling and drainage[J]. Hebei Medicine, 2017, 23(8): 1337-1339.
    [17]
    徐金燕, 夏聪聪, 杨红美. 老年脑卒中肺部感染风险预测模型的建立及验证[J]. 实用老年医学, 2024, 38(5): 452-455, 460.

    XU J Y, XIA C C, YANG H M, et al. Establishment and validation of a Nomogram to predict the risk of pulmonary infection in elderly patients with stroke[J]. Practical Geriatrics, 2024, 38(5): 452-455, 460.
    [18]
    ELOM H A, GANIM I, OWINGS A. S3562neuro-pulmonary syndrome secondary to invasive fungal infection after one year of a liver transplant, a stroke mimicker[J]. Am J Gastroenterol, 2023, 118(10): 2327-2327.
    [19]
    KRAUSS P, REINARTZ F, SONNLEITNER C, et al. The relation of patient expectations, satisfaction, and outcome in surgery of the cervical spine: a prospective study[J]. Spine, 2022, 47(12): 849-858. doi: 10.1097/BRS.0000000000004351
    [20]
    袁燕, 苏洲, 张雪莹. 血清前白蛋白、可溶性白介素-2受体、淀粉样蛋白A水平与老年脑卒中并发肺部感染的相关性[J]. 安徽医药, 2022, 26(5): 995-999.

    YUAN Y, SU Z, ZHANG X Y, et al. Correlation between serum PA, sIL-2R, SAA levels and pulmonary infection in elderly patients with stroke[J]. Anhui Medical and Pharmaceutical Journal, 2022, 26(5): 995-999.
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