Construction of a prediction model for anxiety before local anesthesia in school-age children and its verification
Objective To explore influencing factors for anxiety before local anesthesia in school-age children and to construct a prediction model and verify its performance.Methods This retrospective analysis included 273 school-age children who received local anesthesia in our hospital from January 2022 to August 2023 by convenience sampling.Preoperative anxiety of included school-age children was described and assessed by univariate and multivariate analyses.A prediction model for anxiety before local anesthesia in school-age children was constructed,and its performance was verified.Results Among the included children,the mean score of preoperative anxiety was(34.60±8.17)points.A total of 273 cases scored 30 points.158 cases had preoperative anxiety and 115 cases did not have preoperative anxiety.The incidence of preoperative anxiety was 57.88％.Univariate analysis showed significant differences in age,previous anesthesia experience,pain score during preoperative blood sampling and parents'trait anxiety score between school-age children with preoperative anxiety and those without preoperative anxiety(P＜0.05).Multivariate analysis verified that age,previous anesthesia experience,pain score during preoperative blood sampling and parents'trait anxiety score were independent influencing factors for anxiety in school-age children before local anesthesia(P＜0.05).A nomogram model to predict anxiety before local anesthesia in school-age children was constructed based on the variables screened by multivariate analysis,with the C-index of 0.733 and the average absolute error of the calibration curve of 0.017.Decision curve analysis(DCA)showed that the probability of risk threshold was 13％-94％,and the net benefit rate was＞0.Independent factors of the nomogram and P-value prediction probability were used to predict the occurrence of anxiety in school-age children before local anesthesia.The Youden index of age,previous anesthesia experience,pain score during preoperative blood sampling,parents'trait anxiety score and their combination was 33.02％,17.31％,42.09％,47.96％and 62.59％,respectively.The area under the receiver operating characteristic(ROC)curve(AUC)of P-value prediction probability of the nomogram was significantly higher than that of other independent influencing factors(P＜0.05).Conclusion There is a large proportion of school-age children with anxiety before local anesthesia,and medical staff need to take targeted measures to intervene the anxiety state based on actual conditions,which is conducive to ensuring compliance of surgery and anesthesia and the effectiveness of treatment.
school-agechildrenlocal anesthesiapreoperative anxietyprediction model
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