摘要
目的构建与验证胃肠肿瘤根治术患者麻醉恢复室转出延迟的风险预测模型,为识别转出延迟高风险患者提供评估工具。方法采用回顾性研究方法,选取2020年6月至2021年12月某三甲医院的手术患者511例,分为训练集361例和验证集150例。运用logistic回归分析探索胃肠肿瘤根治术患者麻醉恢复室转出延迟的风险因素,绘制列线图模型,在验证集中验证模型预测效果。结果回归分析结果显示,麻醉ASAⅢ级、低体温、高血压、术中出血>200 mL、中重度贫血5项因素为胃肠肿瘤根治术患者麻醉恢复室转出延迟的主要危险因素。使用这5项因素构建转出延迟风险预测模型,训练集模型ROC曲线下面积为0.805[95%CI(0.752,0.857)],最大约登指数为0.484;验证集模型ROC曲线下面积为0.828[95%CI(0.753,0.914)],最大约登指数为0.569,校准曲线为斜率近似于1的直线。结论本研究构建的风险预测模型具有良好的预测效能,能为临床早期甄别胃肠肿瘤根治术患者麻醉恢复室转出延迟提供参考。
Objective To establish and verify a risk prediction model for prolonged post-anaesthesia care unit(PACU)stay in patients undergoing radical resection of gastrointestinal neoplasms under general anesthesia,and to provide a valid assessment tool for identifying high-risk patients.Methods A retrospective study was conducted to select 511 surgical patients undergoing radical resection of gastrointestinal neoplasms under general anesthesia from a 3A hospital from June 2020 to December 2021.Patients were divided into a modeling group(361 cases)and a validation group(150 cases).Logistic regression analysis was used to explore the risk factors of prolonged PACU stay.Then a nomogram was drawn,and validated for the model prediction efficacy in the validation group.Results Logistic regression analysis identified such five factors affecting prolonged PACU stay in patients undergoing radical resection of gastrointestinal neoplasms under general anesthesia:ASA grading,hypothermia,hypertension,intraoperative bleeding>200 mL and moderate to severe anemia.Then a risk prediction model of prolonged PACU stay was established according to the five factors.The area under receiver operating characteristic curve(ROC)of the modeling group was 0.805[95%CI(0.752,0.857)],and the maximum Youden index was 0.484,versus 0.828[95%CI(0.753,0.914)]and 0.569 in the validation group.The calibration curve was a straight line with the slope approximately 1.Conclusion The risk prediction model has good predictive efficacy and can provide a reference for early clinical screening of patients at risk of prolonged PACU stay after radical resection of gastrointestinal neoplasms under general anesthesia.
作者
王荣
姚明
盛晗
朱志红
周清河
周煦燕
杨国芳
Wang Rong;Yao Ming;Shen Han;Zhu Zhihong;Zhou Qinghe;Zhou Xuyan;Yang Guofang(Anesthesia&Operation Center,Affiliated Hospital of Jiaxing University(The First Hospital of Jia xing),Jiaxing 314000,China)
出处
《护理学杂志》
CSCD
北大核心
2024年第12期55-58,63,共5页
Journal of Nursing Science
基金
嘉兴市第一医院院级课题立项项目(2021YJKY025)
国家临床重点专科建设项目-肿瘤学(2023-GJZK-001)
嘉兴市重点学科支撑学科资助项目-护理学(2023-zc-007)。
关键词
胃肠肿瘤
全麻手术
麻醉恢复室
转出延迟
风险预测
列线图
低体温
高血压
gastrointestinal neoplasms
surgery under general anesthesia
post-anaesthesia care unit
delayed transfer
prediction of risk
nomogram
hypothermia
hypertension
