岭南急诊医学杂志2024，Vol.29Issue(4) ：340-346.DOI:10.3969/j.issn.1671-301X.2024.04.008

麻醉复苏室低体温风险列线图预测模型的建立与验证

Construction and Validation of a Risk Prediction Model for Hypothermia in Pa-tients Undergoing General Anesthesia in Post-anesthesia Care Unit

毛小燕 凌嘉发 朱晓彤
岭南急诊医学杂志2024，Vol.29Issue(4) ：340-346.DOI:10.3969/j.issn.1671-301X.2024.04.008
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  • 维普
  • 万方数据

麻醉复苏室低体温风险列线图预测模型的建立与验证

Construction and Validation of a Risk Prediction Model for Hypothermia in Pa-tients Undergoing General Anesthesia in Post-anesthesia Care Unit

毛小燕 1凌嘉发 1朱晓彤2
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作者信息

  • 1. 中山大学孙逸仙纪念医院麻醉科(510120)
  • 2. 中山大学孙逸仙纪念医院甲状腺外科(510120)
  • 折叠

摘要

目的:分析麻醉复苏室(PACU)患者发生术后低体温的危险因素,构建列线图预测模型并验证效能.方法:便利抽样2022年7月1日-2023年6月30日期间中山大学孙逸仙纪念医院PACU137例低体温患者为低体温组,按照术间进行倾向性匹配292例患者为非低体温组,比较两组患者临床特征,并采用单因素和多因素logistic回归模型分析PACU患者发生低体温独立影响因素,绘制列线图并进行验证.结果:低体温组与非低体温组患者在年龄、BMI、ASA分级、术中是否发生低体温、术中是否冲洗、手术时长、术中出血量、术中输血量、术中输液量、术中是否液体保温等10个指标均有明显差异(P均<0.05).多因素logistic回归分析结果显示,患者ASA分级高(OR=2.441,95%CI:1.388-4.388)、术中发生低体温(OR=30.307,95%CI:10.557-128.713)和术中有冲洗(OR=3.316,95%CI:1.785-6.283)是PACU期间发生低体温的独立危险因素,而BMI>24(OR=0.387,95%CI:0.200,0.728)为独立保护因素.预测模型训练集 ROC 曲线下面积(AUC)值为 0.846(95%CI:0.803-0.890),H-L拟合优度检验显示拟合优度良好(c2=4.313,P=0.828);验证集中ROC曲线下面积为 0.777(95%CI:0.696-0.857),经验证本预测模型具有一定的预测价值.结论:筛选的4项预测因素为PACU发生低体温的特异性因素,建立的风险预测模型有较好的预测效能,临床应针对低体温的危险因素采取积极有效的预防措施.

Abstract

Objective:To investigate the factors affecting the risk of patients with hypothermia in postanesthesia care unit(PACU)and to construct a nomogram prediction model for verification.Methods:A total of 137 patients with hypothermia during PACU period from July 1,2022 to June 30,2023 in SUN Yat-sen Memorial Hospital of SUN Yat-sen University were divided into hypothermia group by convenience sampling,and 292 patients were matched as non-hypo-thermia group according to intraoperational tendencies,and clinical characteristics of the two groups were compared.Mul-tivariate logistic regression model was used to analyze the independent influencing factors of hypothermia during PACU,and the column graph was drawn and verified.Results:There were statistically significant differences between the hypo-thermia group and the non-hypothermia group in 10 indexes,including age,BMI,ASA grade,intraoperative hypother-mia,intraoperative irrigation,operation duration,blood loss,intraoperative blood transfusion,intraoperative infusion,and intraoperative liquid insulation(all P<0.05).Multivariate logistic regression analysis showed that ASA grade was high(OR=2.441,95%CI:1.388-4.388),intraoperative hypothermia(OR=30.307,95%CI:10.557-128.713)and intraopera-tive douching(OR=3.316,95%CI:1.785-6.283)was an independent risk factor for hypothermia during PACU,while BMI>24(OR=0.387,95%CI:0.200,0.728)was an independent protective factor.The area under ROC curve(AUC)value of the predictive model training set was 0.846(95%CI:0.803-0.890)and the Yoden index was 0.549.H-L good-ness of fit test showed good goodness of fit(c2=4.313,P=0.828).The AUC value of the verification set was 0.777(95%CI:0.696-0.857),which proved that the prediction model had certain prediction value.Conclusion:The four pre-dictive factors were specific factors of hypothermia in anesthesia resuscitation room,and the risk prediction model estab-lished had good predictive efficacy.Active preventive measures should be taken for the risk factors of hypothermia in clinic.

关键词

低体温/麻醉/麻醉后复苏室/危险因素/预测模型

Key words

hypothermia/anesthesia/resuscitation room after anesthesia/risk factors/prediction model

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出版年

2024
岭南急诊医学杂志
广东省医学会

岭南急诊医学杂志

影响因子：0.437
ISSN：1671-301X
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