Risk Factors and a Nomogram Construction for Prolonged Length of Hospital Stay in Patients With Peritoneal Dialysis Associated Peritonitis

Jing YAO, Xiaojian BAO, Yafeng ZHANG, Bin WU, Qishun WU

Acta Academiae Medicinae Sinicae ›› 2025, Vol. 47 ›› Issue (2) : 244-250.

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Acta Academiae Medicinae Sinicae

Abbreviation (ISO4): Acta Academiae Medicinae Sinicae      Editor in chief: Xuetao CAO

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Acta Academiae Medicinae Sinicae ›› 2025, Vol. 47 ›› Issue (2) : 244-250. DOI: 10.3881/j.issn.1000-503X.16160
Original Articles

Risk Factors and a Nomogram Construction for Prolonged Length of Hospital Stay in Patients With Peritoneal Dialysis Associated Peritonitis

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Abstract

Objective To analyze the risk factors for prolonged length of hospital stay in patients with peritoneal dialysis associated peritonitis(PDAP)and construct a nomogram based on Logistic regression model.Methods A retrospective study was conducted on patients with PDAP who were hospitalized at the Affiliated Hospital of Jiangsu University from January 2013 to December 2023.Using the 75th percentile of hospitalization time as the cutoff(>21 days),the patients were divided into prolonged length of hospital stay group and normal length of hospital stay group.Clinical data were compared between the two groups.Logistic regression analysis was used to analyze the risk factors for prolonged hospital stay in PDAP patients and to construct a nomogram.Results A total of 131 PDAP patients were included in this study,including 40 cases in prolonged length of hospital stay group and 91 cases in normal length of hospital stay group.Multivariate Logistic regression analysis showed that Gram-negative bacteria detected in ascites(OR=6.012,95% CI=1.878-19.248,P=0.003)and elevated platelet count(OR=1.010,95% CI=1.005-1.015,P<0.001)were independent risk factors for prolonged length of hospital stay,while elevated serum chloride(OR=0.885,95% CI=0.802-0.978,P=0.016)was a protective factor.Based on the above three indicators,a nomogram was constructed.The multivariate Logistic regression model showed an area under the receiver operating characteristic curve(AUC)of 0.755,with an internal validation AUC of 0.727 using the Bootstrap method.The calibration curve indicated that the predicted probability was consistent with the actual probability.The decision curve showed that the model was clinically applicable when the threshold probabilities were 9%-10%,13% and 18%-92%.Conclusion A nomogram,based on the detection of gram-negative bacteria in ascites,platelet count and serum chloride,was helpful for clinical screening PADP patients at risk for prolonged length of hospital stay,and can provide a basis for optimizing clinical decision-making.

Key words

peritoneal dialysis associated peritonitis / prolonged length of hospital stay / nomogram

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Jing YAO , Xiaojian BAO , Yafeng ZHANG , et al . Risk Factors and a Nomogram Construction for Prolonged Length of Hospital Stay in Patients With Peritoneal Dialysis Associated Peritonitis[J]. Acta Academiae Medicinae Sinicae. 2025, 47(2): 244-250 https://doi.org/10.3881/j.issn.1000-503X.16160

References

[1]
Himmelfarb J, Vanholder R, Mehrotra R, et al. The current andfuture landscape of dialysis[J]. Nat Rev Nephrol, 2020, 16(10):573-585.DOI:10.1038/s41581-020-0315-4.
[2]
United States Renal Data System. 2022 USRDS annual data report:end stage renal disease:Chapter 1:incidence,prevalence,patient characteristics,and treatment modalities[DB/OL]. Bethesda,MD:National Institute of Diabetes and Digestive and Kidney Diseases(NIDDK),U.S.Department of Health and Human Services, 2022[2023-08-09]. https://usrds-adr.niddk.nih.gov/2022/end-stage-renal-disease.
[3]
中国腹膜透析相关感染防治专家组. 腹膜透析相关感染的防治指南[J]. 中华肾脏病杂志, 2018, 34(2):139-148.DOI:10.3760/cma.j.issn.1001-7097.2018.02.010.
[4]
Li PK, Szeto CC, Piraino B, et al. ISPD peritonitis recommendations:2016 update on prevention and treatment[J]. Perit Dial Int, 2016, 36(5):481-508.DOI:10.3747/pdi.2016.00078.
[5]
He P, He LJ, Huang C, et al. Neutrophil to lymphocyte ratio and treatment failure in peritoneal dialysis associated peritonitis[J]. Front Med(Lausanne), 2021,8:699502.DOI:10.3389/fmed.2021.699502.
[6]
孙杨杨, 鄢艳, 邹梦林. 维持性血液透析患者发生感染相关住院的临床特征和危险因素分析[J]. 中华肾脏病杂志, 2020, 36(6):435-440.DOI:10.3760/cma.j.cn441217-20191016-00082.
[7]
Teo K, Slark J. A systematic review of studies investigating the care of stroke survivors in long-term care facilities[J]. Disabil Rehabil, 2016, 38(8):715-723.DOI:10.3109/09638288.2015.1059496.
[8]
Paolucci S, Iosa M, Coiro P, et al. Post-stroke depressionincreases disability more than 15% in ischemic stroke survivors:a case-control study[J]. Front Neurol, 2019, 11(14):926.DOI:10.3389/fneur.2019.00926.
[9]
原慧芝, 朱学研, 杨立明, 等. 多中心肺炎克雷伯菌腹膜透析相关性腹膜炎的临床转归及治疗失败的危险因素[J]. 中国医学科学院学报, 2023, 45(2):227-234.DOI:10.3881/j.issn.1000-503X.15138.
[10]
张清淋, 张国强, 占强, 等. 消化性溃疡出血患者住院时间延长的危险因素分析及预测评分模型研究[J]. 中国全科医学, 2021, 24(33):4217-4222.DOI:10.12114/j.issn.1007-9572.2021.02.042.
[11]
Wang SK, Wang P, Li ZE, et al. Development and external validation of a predictive model for prolonged length of hospital stay in elderly patients undergoing lumbar fusion surgery:comparison of three predictive models[J]. Eur Spine J, 2024, 33(3):1044-1054.DOI:10.1007/s00586-024-08132-w.
[12]
于书慧, 韩佳凝, 钟丽君, 等. 术前盆底肌电生理参数对前列腺癌根治性切除术后早期尿失禁的预测价值[J]. 北京大学学报(医学版), 2024, 56(4):594-599.DOI:10.19723/j.issn.1671-167X.2024.04.008.
[13]
Mc Guire AL, Carson CF, Inglis TJ, et al. Effects of a statewide protocol for the management of peritoneal dialysis-relatedperitonitis on microbial profiles and antimicrobial susceptibilities:a retrospective five - year review[J]. Perit DialInt, 2015, 35(7):722-728.DOI:10.3747/pdi.2014.00117.
[14]
Feng X, Yang X, Yi C, et al. Escherichia coli peritonitis inperitoneal dialysis:the prevalence,antibiotic resistance andclinical outcomes in a South China dialysis center[J]. Perit Dial Int, 2014, 34(3):308-316.DOI:10.3747/pdi.2013.00012.
[15]
朱冬菊, 李瑞丰. 老年腹膜透析相关性腹膜炎革兰阴性菌感染的临床特征及其耐药性[J]. 中国感染控制杂志, 2024, 23(9):1084-1090.DOI:10.12138/j.issn.1671-9638.20245081.
[16]
邢虎, 张亚峰, 刘大东, 等. 难治性腹膜透析相关性腹膜炎发生的影响因素与风险评分模型研究[J]. 中华医院感染学杂志, 2019, 29(20):3175-3179.DOI:10.11816/cn.ni.2019-191859.
[17]
张珍, 姜娜, 方炜, 等. 腹膜透析相关性细菌性腹膜炎预后的危险因素分析[J]. 中华肾脏病杂志, 2015, 31(9):647-651.DOI:10.3760/cma.j.issn.1001-7097.2015.09.002.
[18]
Brodská H, Malíčková K, Adámková V, et al. Significantly higher procalcitonin levels could differentiate Gram-negative sepsis from Gram-positive and fungal sepsis[J]. Clin Exp Med, 2013, 13(3):165-170.DOI:10.1007/s10238-012-0191-8.
[19]
Sang Y, Roest M, de Laat B, et al. Interplay between platelets and coagulation[J]. Blood Rev, 2021,46:100733.DOI:10.1016/j.blre.2020.100733.
[20]
Ebermeyer T, Cognasse F, Berthelot P, et al. Platelet innate immune receptors and TLRs:adouble-edged sword[J]. Int J Mol Sci, 2021, 22(15):7894.DOI:10.3390/ijms22157894.
[21]
Buchrits S, Gafter-Gvili A, Bishara J, et al. The importance of abnormal platelet count in patients with Clostridioides difficile infection[J]. J Clin Med, 2021, 10(13):2957.DOI:10.3390/jcm10132957.
[22]
Thomas MR, Storey RF. The role of platelets in inflammation[J]. Thromb Haemost, 2015, 114(3):449-458.DOI:10.1160/TH1412-1067.
[23]
罗军, 邓劲, 康梅. 腹膜透析液培养阳性腹膜炎临床特征[J]. 四川医学, 2024, 45(4):377-382.DOI:10.16252/j.cnki.issn1004-0501-2024.04.008.
[24]
誉翠颜, 谢超, 吴翠霞, 等. 早期血小板计数高是腹膜透析相关性腹膜炎不良预后的独立危险因素[J]. 中华肾脏病杂志, 2020, 36(8):583-587.DOI:10.3760/cma.j.cn441217-20200226-00106.
[25]
Repsold L, Joubert AM. Platelet function,role in thrombosis,inflammation,and consequences in chronic myeloproliferative disorders[J]. Cells, 2021, 10(11):3034.DOI:10.3390/cells10113034.
[26]
Cuthbert JJ, Pellicori P, Rigby A, et al. Low serum chloride in patients with chronic heart failure:clinical associations and prognostic significance:chloride in chronic heart failure[J]. Eur J Heart Fail, 2018, 20(10):1426-1435.DOI:10.1002/ejhf.1247.
[27]
Grodin JL, Sun JL, Anstrom KJ, et al. Implications of serum chloride homeostasis in acute heart failure(from ROSE-AHF)[J]. Am J Cardiol, 2017, 119(1):78-83.DOI:10.1016/j.amjcard.2016.09.014.
[28]
李路洁. 腹膜透析患者基线腹膜转运特征及其变化的影响因素分析[D]. 新乡: 新乡医学院, 2022.
[29]
Li H, Wang Y, Xu Y, et al. Association between serum chloride levels with mortality in incident peritoneal dialysis patients[J]. Nutr Metab Cardiovasc Dis, 2022, 32(3):624-631.DOI:10.1016/j.numecd.2021.12.007.
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