Abstract:

Objective To explore the influencing factors of nosocomial infection in children with malignant tumor after chemotherapy，and to develop a nomogram model to predict these risks. Methods A retrospective study design was adopted. A total of 320 children undergoing chemotherapy for malignant tumors were conveniently selected as the modeling group between June 2023 and May 2024 in a tertiary A hospital in Zhengzhou. Data were collected through the electronic medical record system. Then，a prospective study design was used to select 140 children with malignant tumors undergoing chemotherapy from June 2024 to November 2024 as the validation group. Logistic regression analysis was used to determine the risk factors of nosocomial infection. A nomogram was developed by R4.3.3 software and validated to predict the risk of nosocomial infection in children with malignant tumor after chemotherapy. Results Logistic regression analysis showed that hospital stays≥11 d，white blood cell count≤4 × 10⁹/L，neutrophil count≤2 × 10⁹/L，serum albumin<35 g/L were independent risk factors of nosocomial infection in children with malignant tumor after chemotherapy（P<0.05）. The Hosmer-Lemeshow test of the model was P=0.943，the area under the ROC curve was 0.868，the best cutoff value was 0.400，the sensitivity was 0.902，the specificity was 0.697. The model validation results showed that the area under the ROC curve was 0.873，reflecting a good fitting effect of the risk prediction model. Conclusion The risk prediction model constructed in this study has good discrimination and accuracy. It can be used to predict the risk of nosocomial infection in children with malignant tumor after chemotherapy，providing the reference for management and preventative intervention strategies for high-risk children.

Key words: Children, Malignant neoplasms, Chemotherapy, Nosocomial infection, Prediction model