首页|非体外心脏复合手术患者非计划性术中低体温的影响因素分析及风险预测模型构建

非体外心脏复合手术患者非计划性术中低体温的影响因素分析及风险预测模型构建

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目的 分析非体外心脏复合手术患者非计划性术中低体温(IIH)的影响因素,构建列线图预测模型。方法 收集该院2019年1月至2022年12月429例非体外心脏复合手术患者的临床资料,以是否发生IIH为结局指标。采用单因素及多因素logistic回归分析筛选出有意义的独立影响因素,并构建列线图模型。使用受试者工作特征(ROC)曲线下面积(AUC)值评价模型的区分度,使用校准曲线评价模型的一致性,并采用Bootstrap重抽样法进行内部验证。结果 429例患者中IIH的发生率为72。26%。多因素logistic回归分析显示,基础体温、术中肝素剂量、BMI、加温方式、麻醉持续时间为非体外心脏复合手术患者发生IIH的独立影响因素。构建的列线图模型AUC值为0。916(95%CI:0。885~0。947),具有较好的区分度及一致性。结论 本研究构建的列线图模型预测价值较高,可为临床IIH防护措施的开展提供参考依据。
Analysis on influencing factors of inadvertent intraoperative hypothermia in patients with non-in vitro cardiac hybrid operation and construction of risk prediction model
Objective To analyze the risk factors of inadvertent intraoperative hypothermia (IIH) in the patients with non-in vitro cardiac hybrid operation,and to construct a nomogram prediction model. Methods The clinical data in 429 cases of non-in vitro cardiac hybrid surgery in this hospital during 2019-2022 were collected.Whether IIH occurring served as the outcome indicator.The univariate and multivariate logistic regression analyses were used to screen out the significant independent influencing factors,and the no-mogram model was constructed.The area under the receiver operating characteristic (ROC) curve was used to evaluate the discrimination of the model,the calibration curve was used to evaluate the consistency of the mod-el,and the Bootstrap resampling method was used for conducting the internal validation.Results The inci-dence rate of IIH in 429 cases was 72.26%.The multivariate logistic regression analysis showed that the basal body temperature,intraoperative heparin use amount,BMI,warming methods and anesthesia duration were the independent influencing factors for the IIH occurrence in the patients with non-in vitro cardiac hybrid op-eration.The AUC value of the constructed nomogram model was 0.916 (95%CI:0.885-0.947) with good discrimination and consistency.Conclusion The nomogram model constructed in this study has the high pre-dictive value,which could provide the reference data for carrying out clinical IIH preventive measures.

inadvertent intraoperative hypothermiahybrid operationprediction modelnomogram

卞海磊、范明思、倪荔

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同济大学医学院,上海 200092

同济大学附属东方医院手术室,上海 200120

同济大学附属东方医院护理部,上海 200120

非计划性术中低体温 复合手术 预测模型 列线图

上海市浦东新区卫生系统学科带头人培养计划项目上海市东方医院(同济大学附属东方医院)天使计划暨青年护士成长计划项目

PWRd2021-19DFTS-2242

2024

重庆医学
重庆市卫生信息中心,重庆市医学会

重庆医学

CSTPCD
影响因子:1.797
ISSN:1671-8348
年,卷(期):2024.53(16)