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目的评价感染可能性评分对预测白血病患者血流感染发生的可行性。方法选择2011年2月-2013年10月期间,某院血液内科明确诊断为急性或慢性髓细胞白血病、淋巴细胞白血病患者作为研究对象。根据血流感染的诊断标准,将入组患者分为血流感染组(BSI组)及非感染组,对2组研究对象进行IPS评分,比较BSI组及非感染组IPS评分的差异。同时,根据文献中提出的IPS评分界值(13分),以BSI的诊断为金标准,进行IPS评分的灵敏度、特异度、阳性预测值、阴性预测值评估。结果 BSI组IPS评分为(15.2±2.9)分,非感染组IPS评分为(11.5±2.1)分,2组评分的差异有统计学意义,BSI组IPS评分高于非感染组(t=4.775,P<0.001)。IPS评分真阳性7例,真阴性54例,假阳性19例,假阴性2例,灵敏度为77.78%,特异度为73.97%,阳性预测值为26.90%,假阳性率为26.03%,假阴性率为2.22%,阴性预测值为96.40%,一致率为74.40%,正确指数为51.75%。结论感染可能性评分可以作为预测患者血流感染的工具,具有简单、快捷的特点,能够为今后针对性的预防患者血流感染提供参考。
Objective To evaluate the feasibility of infection possibility score in predicting bloodstream infection in patients with leukemia. Methods From February 2011 to October 2013, a patient with acute myelocytic leukemia or lymphocytic leukemia was diagnosed as a definite target of hematology in a hospital. According to the diagnostic criteria of bloodstream infection, the patients were divided into the bloodstream infection group (BSI group) and the non-infected group. The IPS scores of the two groups were compared, and the differences of the IPS scores between the BSI group and the non-infected group were compared. At the same time, the sensitivity, specificity, positive predictive value and negative predictive value of IPS score were evaluated according to the IPS score cut-off value (13 points) in the literature and the BSI diagnosis as the gold standard. Results The IPS score of BSI group was (15.2 ± 2.9) points and that of non-infected group was (11.5 ± 2.1). There was significant difference between the two groups, and the IPS score of BSI group was higher than that of non-infected group (t = 4.775, P <0.001). The true positive score of IPS was 7, the true negative was 54, the false positive was 19 and the false negative was 2, the sensitivity was 77.78%, the specificity was 73.97%, the positive predictive value was 26.90%, the false positive rate was 26.03% Was 2.22%, the negative predictive value was 96.40%, the agreement rate was 74.40%, and the correct index was 51.75%. Conclusion The possibility of infection score can be used as a tool to predict blood flow in patients with simple and quick features, which can provide reference for future targeted prevention of bloodstream infections in patients.