中华现代护理杂志2024,Vol.30Issue(32) :4399-4407.DOI:10.3760/cma.j.cn115682-20240130-00599

老年患者结肠镜围检查期低血糖风险预测模型的构建与验证

Construction and validation of a risk prediction model for hypoglycemia in elderly patients during peri-colonoscopy period

邵艳茹 刘磊 郑桃花 宋文 张凌云 于萌 单信芝
中华现代护理杂志2024,Vol.30Issue(32) :4399-4407.DOI:10.3760/cma.j.cn115682-20240130-00599

老年患者结肠镜围检查期低血糖风险预测模型的构建与验证

Construction and validation of a risk prediction model for hypoglycemia in elderly patients during peri-colonoscopy period

邵艳茹 1刘磊 2郑桃花 3宋文 3张凌云 3于萌 3单信芝4
扫码查看

作者信息

  • 1. 青岛大学护理学院,青岛 266000
  • 2. 济南市第四人民医院消化内科,济南 250031
  • 3. 青岛大学附属医院消化内科,青岛 266000
  • 4. 青岛大学附属医院服务管理部,青岛 266000
  • 折叠

摘要

目的 分析老年患者结肠镜围检查期低血糖的影响因素,并构建、验证风险预测模型.方法 通过文献回顾、半结构式访谈确定老年患者结肠镜围检查期低血糖影响因素条目池,经过2轮德尔菲专家函询确定调查问卷.采用便利抽样法,选取2023年1-9月在青岛大学附属医院消化内科行结肠镜检查的老年患者为研究对象进行问卷调查.采用单因素和多因素Logistic回归分析探讨老年患者结肠镜围检查期低血糖的影响因素,并绘制老年患者结肠镜围检查期低血糖风险列线图模型.采用受试者工作特征曲线下面积(4UC)和Hosmer-Lemeshow拟合优度检验评价模型的预测效果;采用临床决策曲线(DCA)评价模型的临床获益能力.结果 共发放问卷558份(建模组392份、验证组166份),回收有效问卷558份,问卷有效回收率为100.00%.558例老年患者中,共130例(建模组89例,验证组41例)在结肠镜围检查期发生低血糖,低血糖的发生率为23.30%.多因素Logistic回归分析显示,血清白蛋白、年龄、既往低血糖次数、应用胰岛素、禁食时长和营养风险是老年患者结肠镜围检查期低血糖发生的独立影响因素(均P<0.05).建模组和内部验证组的AUC分别为0.933、0.899;Hosmer-Lemeshow检验显示,模型具有良好的校准度;DCA曲线显示,模型具有较好的临床有效性.结论 本研究绘制的列线图模型预测效果良好,可直观、简洁地预测老年结肠镜围检查期患者的低血糖风险,为医护人员提供参考.

Abstract

Objective To explore the influencing factors for hypoglycemia in elderly patients during peri-colonoscopy,construct and validate a risk prediction model.Methods The factors influencing hypoglycemia in elderly patients during the peri-colonoscopy period were identified through a literature review and semi-structured interviews.After two rounds of Delphi expert consultation,the survey questionnaire was determined.From January to September 2023,convenience sampling was used to select elderly patients who underwent colonoscopy in the Department of Gastroenterology at the Affiliated Hospital of Qingdao University as participants for a questionnaire survey.Univariate and multivariate Logistic regression was used to explore the influencing factors of hypoglycemia in elderly patients during the peri-colonoscopy period,and a nomogram model of hypoglycemia risk in elderly patients during the peri-colonoscopy period was drawn.The area under the receiver operating characteristic curve(AUC)of the subjects and the Hosmer-Lemeshow goodness of fit test were used to evaluate the model's predictive performance.The clinical decision curve of DCA was implemented to evaluate the model's clinical benefit ability.Results A total of 558 questionnaires were distributed(392 for the modeling group and 166 for the validation group)and 558 valid questionnaires were collected,with a valid response rate of 100.00%.Among 558 elderly patients,a total of 130 cases(89 in the modeling group and 41 in the validation group)experienced hypoglycemia during the peri-colonoscopy period,with an incidence of 23.30%.Multivariate Logistic regression analysis showed that serum albumin,age,previous hypoglycemia frequency,insulin use,fasting time,and nutritional risk were independent influencing factors(all P<0.05).The AUCs of the modeling and validation groups were 0.933 and 0.899,respectively.Hosmer Lemeshow test showed that the model had good calibration accuracy,and the DCA curve indicated that the model had good clinical effectiveness.Conclusions The nomogram model has good predictive performance and can intuitively and concisely predict the risk of hypoglycemia in elderly patients during the peri-colonoscopy period,providing reference for medical and nursing staff.

关键词

老年人/结肠镜检查/围检查期/低血糖/风险预测模型/列线图

Key words

Aged/Colonoscopy/Peri-examination period/Hypoglycemia/Risk prediction model/Nomograms

引用本文复制引用

出版年

2024
中华现代护理杂志
中华医学会

中华现代护理杂志

CSTPCD
影响因子:1.14
ISSN:1674-2907
段落导航相关论文