消化系统手术患者术中低体温风险预测模型的构建与验证
Construction and verification of an intraoperative hypothermia risk prediction model for patients undergoing digestive system surgery
张晨霞 1张玉娟 1诸亮2
作者信息
- 1. 南京医科大学附属常州第二人民医院手术室,江苏 常州,213018
- 2. 南京医科大学附属常州第二人民医院麻醉科,江苏常州,213018
- 折叠
摘要
目的 探讨消化系统手术患者术中低体温的影响因素,利用数据构建列线图模型并实施验证.方法 便利性的选择在南京医科大学附属常州第二人民医院 2023 年 1 月—2023 年 12 月期间接受消化系统手术的患者 460 人的数据资料实施回顾性分析.描述消化系统手术患者术中低体温的发生情况.消化系统手术患者术中低体温的单因素分析、多因素分析.消化系统手术患者术中低体温的预测模型构建和预测效能分析.结果 在本次参与调查的 460 名接受消化系统手术的患者人群中,最终认定发生术中低体温的共283 人,即术中低体温发生率为 61.52%.单因素分析结果显示,未发生术中低体温和发生术中低体温患者的手术室洁净度、手术分级、麻醉时间、手术开始时的基础体温的数据差异有统计学意义(P<0.05).logistic多因素分析结果显示,手术室洁净度、手术分级、麻醉时间、手术开始时的基础体温是消化系统手术患者术中发生低体温的独立影响因素(P<0.05).利用logistic回归模型的独立影响因素以及P值预测概率对消化系统手术患者术中低体温的发生情况进行ROC曲线的预测,曲线下面积分别为 0.634,0.685,0.716,0.659,0.858.结论 消化系统手术的患者术中出现低体温的风险较高,手术室洁净度、手术分级、麻醉时间、手术开始时的基础体温是消化系统手术患者术中发生低体温的独立影响因素;而基于各影响因素的预测模型能够较为良好的预测消化系统手术的患者术中出现低体温的结果.
Abstract
Objective To investigate the influencing factors of intraoperative hypothermia in patients undergoing digestive system surgery,and to construct a nomogram model with the data for verification.Methods The data of 460 patients who underwent digestive system surgery in the Affiliated Changzhou No.2 People's Hospital of Nanjing Medical University from January 2023 to December 2023 were retrospectively analyzed.The occurrence of intraoperative hypothermia in patients undergoing digestive system surgery was described.Univariate and multivariate analysis of intraoperative hypothermia in patients undergoing digestive system surgery was applied.A predictive model was constructed and the predictive efficacy of intraoperative hypothermia in patients undergoing digestive system surgery was analyzed.Results Among the 460 patients who underwent digestive system surgery,283 were finally identified as having intraoperative hypothermia,and the incidence of intraoperative hypothermia was 61.52%.Univariate analysis showed that there were statistically significant differences in operating room cleanliness,surgical grade,anesthesia time and basal body temperature at the beginning of surgery between patients without intraoperative hypothermia and patients with intraoperative hypothermia(P<0.05).Logistic multivariate analysis showed that the cleanliness of operating room,surgical grade,anesthesia time,and basal body temperature at the beginning of surgery were independent influencing factors for intraoperative hypothermia in patients undergoing digestive system surgery(P<0.05).The independent influencing factors of logistic regression model and the prediction probability of P-value were used to predict the occurrence of intraoperative hypothermia in patients with digestive system surgery.The area under the curve was 0.634,0.685,0.716,0.659 and 0.858,respectively.Conclusions The risk of intraoperative hypothermia is high in patients undergoing digestive system surgery.The cleanliness of operating room,operation grade,anesthesia time,and basal body temperature at the beginning of surgery are independent influencing factors for intraoperative hypothermia in patients undergoing digestive system surgery.The predictive model based on various influencing factors can better predict the outcome of intraoperative hypothermia in patients undergoing digestive system surgery.
关键词
消化系统/低体温/预测模型/手术室洁净度/麻醉时间Key words
the digestive system/hypothermia/prediction model/operating room cleanliness/duration of anesthesia引用本文复制引用
出版年
2024
NETL
NSTL
万方数据