Background Cardiopulmonary bypass （CPB） has been shown to be associated with a systemic inflammatory response leading to postoperative organ dysfunction. Elucidating the underlying mechanisms and developing protecti...Background Cardiopulmonary bypass （CPB） has been shown to be associated with a systemic inflammatory response leading to postoperative organ dysfunction. Elucidating the underlying mechanisms and developing protective strategies for the pathophysiological consequences of CPB have been hampered due to the absence of a satisfactory recovery animal model. The purpose of this study was to establish a good rat model of CPB to study the pathophysiology of potential complications. Methods Twenty adult male Sprague-Dawley rats weighing 450-560 g were randomly divided into a CPB group （n=10） and a control group （n=10）. All rats were anaesthetized and mechanically ventilated. The carotid artery and jugular vein were cannulated. The blood was drained from the right atrium via the right jugular and transferred by a miniaturized roller pump to a hollow fiber oxygenator and back to the rat via the left carotid artery. Priming consisted of 8 ml of homologous blood and 8 ml of colloid. The surface of the hollow fiber oxygenator was 0.075 m~. CPB was conducted for 60 minutes at a flow rate of 100-120 ml. kg-1. min-1 in the CPB group. Oxygen flow/perfusion flow was 0.8 to 1.0, and the mean arterial pressure remained 60-80 mmHg. Blood gas analysis, hemodynamic investigations, and lung histology were subsequently examined. Results All CPB rats recovered from the operative process without incident. Normal cardiac function after successful weaning was confirmed by electrocardiography and blood pressure measurements. Mean arterial pressure remained stable. The results of blood gas analysis at different times were within the normal range. Levels of IL-113 and TNF-a were higher in the lung tissue in the CPB group （P 〈0.005）. Histological examination revealed marked increases in interstitialcongestion, edema, and inflammation in the CPB group. Conclusion This novel, recovery, and reproducible minimally invasive CPB model may open the field for various studies on the pathophysiological process of CPB and systemic ischemia-reperfusion injury in vivo.展开更多
Background Cardiopulmonary bypass （CPB） has been shown to be associated with systemic inflammatory response leading to postoperative organ dysfunction. Elucidating the underlying mechanisms and developing protective...Background Cardiopulmonary bypass （CPB） has been shown to be associated with systemic inflammatory response leading to postoperative organ dysfunction. Elucidating the underlying mechanisms and developing protective strategies for the pathophysiological consequences of CPB have been hampered due to the absence of a satisfactory recovery animal model. The purpose of this study was to establish a novel, minimally invasive rat model of normothermic CPB model without blood priming. Methods Twenty adult male Sprague-Dawley rats weighing 450-560 g were randomly divided into CPB group （n=10） and control group （n=10）. All rats were anaesthetized and mechanically ventilated. The carotid artery and jugular vein were cannulated. The blood was drained from the right atrium via the right jugular and further transferred by a miniaturized roller pump to a hollow fiber oxygenator and back to the rat via the left carotid artery. The volume of the priming solution, composed of 6% HES130/0.4 and 125 IU heparin, was less than 12 ml. The surface of the hollow fiber oxygenator was 0.075 m2. CPB was conducted for 60 minutes at a flow rat of 100-120 ml. kg -1. min-1 in CPB group. Oxygen flow/perfusion flow was 0.8 to 1.0, and the mean arterial pressure remained 60-80 mmHg. Results All CPB processes were successfully achieved. Blood gas analysis and hemodynamic parameters of each time point were in accordance with normal ranges. The vital signs of all rats were stable. Conclusions The establishment of CPB without blood priming in rats can be achieved successfully. The nontransthoracic model should facilitate the investigation of pathophysiological processes concerning CPB-related multiple organ dysfunction and possible protective interventions. This novel, recovery, and reproducible minimally invasive CPB model may open the tield tor various studies on the pathophysiological process of CPB and systemic ischemia-reperfusion injury in vivo.展开更多
We investigated the effect of Granulocyte-Colony Stimulating Factor (G-CSF) on expression of pro- and anti-inflammatory proteins in the striatum of new- born piglet brain following cardiopulmonary bypass (CPB) and dee...We investigated the effect of Granulocyte-Colony Stimulating Factor (G-CSF) on expression of pro- and anti-inflammatory proteins in the striatum of new- born piglet brain following cardiopulmonary bypass (CPB) and deep hypothermic circulatory arrest (DHCA). Piglets were placed on CPB, cooled to 18?C, subjected to 30 min of DHCA and 1 h of low-flow (20 ml/kg/min), rewarmed to 37?C, separated from CPB circuit and monitored for 2 h. Striatum was then isolated for protein analysis. The levels of proteins are presented relative to the mean in the control group (mean ± SEM, n = 6). DHCA increased the levels of pro-inflammatory proteins: IL-1alpha (158% ± 23%, P = 0.05), IL-6 (152% ± 16%, P = 0.03), TNF-alpha (144% ± 2%, P = 0.003), MIP-3 alpha (148% ± 12.6%, P = 0.03), NAP-3 (216% ± 16%, P = 0.05), GRO (165% ± 19%, P = 0.03) and BLC (140.4 ± 15%, P = 0.05). Compared to DHCA, the G-CSF-treated group had significantly decreased levels of IL-6 (110.8% ± 11% vs. 152% ± 16%, P = 0.05), TNF-alpha (120.6% ± 5.4% vs. 144% ± 2%, P = 0.001), MIP-3 alpha (148% ± 12.6% vs. 104.8% ± 13%, P = 0.02) and NAP-2 (216% ± 16% vs. 122% ± 23%, P = 0.002). The levels of anti-inflammatory proteins did not change in DHCA group compared to control, except for VEGF which decreased to 37.5% ± 9%, P = 0.003. The levels of all protective proteins in the G-CSF group increased versus the DHCA group, but the increases did not attain a P value of 0.05. Conclusions: In an immature brain subjected to circulatory arrest, the early inflammatory response in the striatum is diminished by pretreatment with G-CSF.展开更多
In this paper, the subject of mathematical model is a series of math expressions, which is used to calculate different regions＇ volume fraction and analyze flow characterization in multi-strand tundish. But research ...In this paper, the subject of mathematical model is a series of math expressions, which is used to calculate different regions＇ volume fraction and analyze flow characterization in multi-strand tundish. But research about mathematical model for multi-strand tundish is few, and so far, there has been no acknowledged math model for multi- strand tundish to describe its flow characteristic. If Sahai＇s model, which is originally proposed for the case of single-strand tundish （proposed in reference, and this model is widely used in the world）, is applied to describe flow feature in multi-strand tundish, the calculation results would be unreasonable. Based on the data of watermodel experiment results, the sum of each strand＇s dead region＇s volume fraction is bigger than 100%, and this obviously doesn＇T agree with reality; and the value of dead region＇s volume fraction is calculated to be minus according to mathematical simulation results data in another case. What＇s more, Sahai＇s model does not propose the standard of plotting the RTD-curve, and this makes scholars around the world can＇t achieve consensus of views about plotting RTD-curve. And the model doesn＇t consider the bypass flow and can＇t calculate its volume fraction, but bypass flow is critical to tundish metallurgy. And through Sahai＇s model, the calculation result of plug flow region＇s volume fraction is also not reasonable, because the model doesn＇t well describe the essence of plug flow. So these suggest that it is not reliable to apply Sahai＇s single-strand tundish model to multi-strand tundish case. Then a new model is attempted to propose in this paper for your discussion. In the new model, the standard of plotting RTD curve is definitely proposed, and relative calculation method is also proposed; and the feature of dead region is carefully studied and the model proposes a new method to calculate its volume fraction, and the calculation formula about its volume fraction can be adjustable according the actual demand; what＇s more, the new model considers the bypass flow and proposes a method to calculate its volume fraction for the first time, and then volume fraction of plug flow region, backmix flow region, dead region and bypass flow can be calculated and obtained at the same time; and this new model can better capture the deviation of reality flow pattern from ideal plug flow pattern, and reflects the feature of plug flow.展开更多
Background: Risk stratification of long-term outcomes for patients undergoing Coronary artery bypass grafting has enormous potential clinical importance. Aim: To develop risk stratification models for predicting long-...Background: Risk stratification of long-term outcomes for patients undergoing Coronary artery bypass grafting has enormous potential clinical importance. Aim: To develop risk stratification models for predicting long-term outcomes following coronary artery bypass graft (CABG) surgery. Methods: We retrospectively revised the electronic medical records of 2330 patients who underwent adult Cardiac surgery between August 2016 and December 2022 at Madinah Cardiac Center, Saudi Arabia. Three hundred patients fulfilled the eligibility criteria of CABG operations with a complete follow-up period of at least 24 months, and data reporting. The collected data included patient demographics, comorbidities, laboratory data, pharmacotherapy, echocardiographic parameters, procedural details, postoperative data, in-hospital outcomes, and follow-up data. Our follow-up was depending on the clinical status (NYHA class), chest pain recurrence, medication dependence and echo follow-up. A univariate analysis was performed between each patient risk factor and the long-term outcome to determine the preoperative, operative, and postoperative factors significantly associated with each long-term outcome. Then a multivariable logistic regression analysis was performed with a stepwise, forward selection procedure. Significant (p < 0.05) risk factors were identified and were used as candidate variables in the development of a multivariable risk prediction model. Results: The incidence of all-cause mortality during hospital admission or follow-up period was 2.3%. Other long-term outcomes included all-cause recurrent hospitalization (9.8%), recurrent chest pain (2.4%), and the need for revascularization by using a stent in 5 (3.0%) patients. Thirteen (4.4%) patients suffered heart failure and they were on the maximum anti-failure medications. The model for predicting all-cause mortality included the preoperative EF ≤ 35% (AOR: 30.757, p = 0.061), the bypass time (AOR: 1.029, p = 0.003), and the duration of ventilation following the operation (AOR: 1.237, p = 0.021). The model for risk stratification of recurrent hospitalization comprised the preoperative EF ≤ 35% (AOR: 6.198, p p = 0.023), low postoperative cardiac output (AOR: 3.622, p = 0.007), and the development of postoperative atrial fibrillation (AOR: 2.787, p = 0.038). Low postoperative cardiac output was the only predictor that significantly contributed to recurrent chest pain (AOR: 11.66, p = 0.004). Finally, the model consisted of low postoperative cardiac output (AOR: 5.976, p < 0.001) and postoperative ventricular fibrillation (AOR: 4.216, p = 0.019) was significantly associated with an increased likelihood of the future need for revascularization using a stent. Conclusions: A risk prediction model was developed in a Saudi cohort for predicting all-cause mortality risk during both hospital admission and the follow-up period of at least 24 months after isolated CABG surgery. A set of models were also developed for predicting long-term risks of all-cause recurrent hospitalization, recurrent chest pain, heart failure, and the need for revascularization by using stents.展开更多
目的探讨成年冠心病患者行冠状动脉旁路移植术(coronary artery bypass grafting,CABG)出院后30 d内非计划再入院的相关因素,构建风险预测模型并进行验证。方法回顾性分析2020年1月—2024年6月于南京市第一医院行单纯CABG患者的临床资...目的探讨成年冠心病患者行冠状动脉旁路移植术(coronary artery bypass grafting,CABG)出院后30 d内非计划再入院的相关因素,构建风险预测模型并进行验证。方法回顾性分析2020年1月—2024年6月于南京市第一医院行单纯CABG患者的临床资料。将2020年1月—2023年8月患者纳入训练集,2023年9月—2024年6月患者纳入验证集。在训练集中,根据出院后30 d内有无非计划再入院,将患者分为再入院组和非再入院组,并比较两组临床资料,利用logistic回归分析确定非计划再入院的独立危险因素,构建风险预测模型及列线图,内部评价模型效能;并利用验证集资料作验证。结果纳入患者2460例,其中男1787例、女673例,中位年龄70(34,89)岁。训练集1932例,验证集528例。训练集中再入院组(79例)与非再入院组(1853例)患者性别、年龄、颈动脉狭窄、心肌梗死病史、术前贫血、心功能分级等差异有统计学意义(P<0.05)。术后切口愈合不良、肺部感染和新发心房颤动为再入院的主要原因。多因素l o g i s t i c回归分析显示,女性[O R=1.659,95%CI(1.022,2.692),P=0.041]、年龄[OR=1.042,95%CI(1.011,1.075),P=0.008]、颈动脉狭窄[OR=1.680,95%CI(1.130,2.496),P=0.010]、首次ICU停留时间[OR=1.359,95%CI(1.195,1.545),P<0.001]及二次入ICU[OR=4.142,95%CI(1.507,11.383),P=0.006]是非计划再入院的独立危险因素。内部评价中,曲线下面积为0.806,临床决策曲线净获益率>3%;验证集中,曲线下面积为0.732,临床决策曲线净获益率为3%~48%。结论女性、年龄、颈动脉狭窄、首次ICU停留时间及二次入ICU是单纯CABG术后出院30 d内非计划再入院的独立危险因素,构建的列线图具有良好的预测作用。展开更多
基金This study was supported by grants from the Capital Medical University-Clinical Research Cooperation Fund （No. l lJLS0, No. 13JL26）, the National Natural Science Foundation of China （No. 81371443, No. 81070055）, Beijing Natural Science Foundation （No. 7112046, No. 7122056）, Beijing Health System High Level Health Technical Personnel Training Plan （No. 2011-1-4）, and the Specialized Research Fund for the Doctoral Program of Higher Education （SRFDP, No. 20111107110006）.
文摘Background Cardiopulmonary bypass （CPB） has been shown to be associated with a systemic inflammatory response leading to postoperative organ dysfunction. Elucidating the underlying mechanisms and developing protective strategies for the pathophysiological consequences of CPB have been hampered due to the absence of a satisfactory recovery animal model. The purpose of this study was to establish a good rat model of CPB to study the pathophysiology of potential complications. Methods Twenty adult male Sprague-Dawley rats weighing 450-560 g were randomly divided into a CPB group （n=10） and a control group （n=10）. All rats were anaesthetized and mechanically ventilated. The carotid artery and jugular vein were cannulated. The blood was drained from the right atrium via the right jugular and transferred by a miniaturized roller pump to a hollow fiber oxygenator and back to the rat via the left carotid artery. Priming consisted of 8 ml of homologous blood and 8 ml of colloid. The surface of the hollow fiber oxygenator was 0.075 m~. CPB was conducted for 60 minutes at a flow rate of 100-120 ml. kg-1. min-1 in the CPB group. Oxygen flow/perfusion flow was 0.8 to 1.0, and the mean arterial pressure remained 60-80 mmHg. Blood gas analysis, hemodynamic investigations, and lung histology were subsequently examined. Results All CPB rats recovered from the operative process without incident. Normal cardiac function after successful weaning was confirmed by electrocardiography and blood pressure measurements. Mean arterial pressure remained stable. The results of blood gas analysis at different times were within the normal range. Levels of IL-113 and TNF-a were higher in the lung tissue in the CPB group （P 〈0.005）. Histological examination revealed marked increases in interstitialcongestion, edema, and inflammation in the CPB group. Conclusion This novel, recovery, and reproducible minimally invasive CPB model may open the field for various studies on the pathophysiological process of CPB and systemic ischemia-reperfusion injury in vivo.
基金This study was supported by grants from the Capital Medical University-Clinical Research Cooperation Fund （No. 11JL50, No. 13JL26）, the National Natural Science Foundation of China （No. 30670928, No. 81070055）, Beijing Natural Science Foundation （No. 7142137, No. 7122056）, Beijing Health System High Level Health Technical Personnel Training Plan （No. 2011-1-4）, and Specialized Research Fund for the Doctoral Program of Higher Education （SRFDP, No. 20111107110006）
文摘Background Cardiopulmonary bypass （CPB） has been shown to be associated with systemic inflammatory response leading to postoperative organ dysfunction. Elucidating the underlying mechanisms and developing protective strategies for the pathophysiological consequences of CPB have been hampered due to the absence of a satisfactory recovery animal model. The purpose of this study was to establish a novel, minimally invasive rat model of normothermic CPB model without blood priming. Methods Twenty adult male Sprague-Dawley rats weighing 450-560 g were randomly divided into CPB group （n=10） and control group （n=10）. All rats were anaesthetized and mechanically ventilated. The carotid artery and jugular vein were cannulated. The blood was drained from the right atrium via the right jugular and further transferred by a miniaturized roller pump to a hollow fiber oxygenator and back to the rat via the left carotid artery. The volume of the priming solution, composed of 6% HES130/0.4 and 125 IU heparin, was less than 12 ml. The surface of the hollow fiber oxygenator was 0.075 m2. CPB was conducted for 60 minutes at a flow rat of 100-120 ml. kg -1. min-1 in CPB group. Oxygen flow/perfusion flow was 0.8 to 1.0, and the mean arterial pressure remained 60-80 mmHg. Results All CPB processes were successfully achieved. Blood gas analysis and hemodynamic parameters of each time point were in accordance with normal ranges. The vital signs of all rats were stable. Conclusions The establishment of CPB without blood priming in rats can be achieved successfully. The nontransthoracic model should facilitate the investigation of pathophysiological processes concerning CPB-related multiple organ dysfunction and possible protective interventions. This novel, recovery, and reproducible minimally invasive CPB model may open the tield tor various studies on the pathophysiological process of CPB and systemic ischemia-reperfusion injury in vivo.
文摘We investigated the effect of Granulocyte-Colony Stimulating Factor (G-CSF) on expression of pro- and anti-inflammatory proteins in the striatum of new- born piglet brain following cardiopulmonary bypass (CPB) and deep hypothermic circulatory arrest (DHCA). Piglets were placed on CPB, cooled to 18?C, subjected to 30 min of DHCA and 1 h of low-flow (20 ml/kg/min), rewarmed to 37?C, separated from CPB circuit and monitored for 2 h. Striatum was then isolated for protein analysis. The levels of proteins are presented relative to the mean in the control group (mean ± SEM, n = 6). DHCA increased the levels of pro-inflammatory proteins: IL-1alpha (158% ± 23%, P = 0.05), IL-6 (152% ± 16%, P = 0.03), TNF-alpha (144% ± 2%, P = 0.003), MIP-3 alpha (148% ± 12.6%, P = 0.03), NAP-3 (216% ± 16%, P = 0.05), GRO (165% ± 19%, P = 0.03) and BLC (140.4 ± 15%, P = 0.05). Compared to DHCA, the G-CSF-treated group had significantly decreased levels of IL-6 (110.8% ± 11% vs. 152% ± 16%, P = 0.05), TNF-alpha (120.6% ± 5.4% vs. 144% ± 2%, P = 0.001), MIP-3 alpha (148% ± 12.6% vs. 104.8% ± 13%, P = 0.02) and NAP-2 (216% ± 16% vs. 122% ± 23%, P = 0.002). The levels of anti-inflammatory proteins did not change in DHCA group compared to control, except for VEGF which decreased to 37.5% ± 9%, P = 0.003. The levels of all protective proteins in the G-CSF group increased versus the DHCA group, but the increases did not attain a P value of 0.05. Conclusions: In an immature brain subjected to circulatory arrest, the early inflammatory response in the striatum is diminished by pretreatment with G-CSF.
基金supported by the National Natural Science Foundation of China(No.60672145)
文摘In this paper, the subject of mathematical model is a series of math expressions, which is used to calculate different regions＇ volume fraction and analyze flow characterization in multi-strand tundish. But research about mathematical model for multi-strand tundish is few, and so far, there has been no acknowledged math model for multi- strand tundish to describe its flow characteristic. If Sahai＇s model, which is originally proposed for the case of single-strand tundish （proposed in reference, and this model is widely used in the world）, is applied to describe flow feature in multi-strand tundish, the calculation results would be unreasonable. Based on the data of watermodel experiment results, the sum of each strand＇s dead region＇s volume fraction is bigger than 100%, and this obviously doesn＇T agree with reality; and the value of dead region＇s volume fraction is calculated to be minus according to mathematical simulation results data in another case. What＇s more, Sahai＇s model does not propose the standard of plotting the RTD-curve, and this makes scholars around the world can＇t achieve consensus of views about plotting RTD-curve. And the model doesn＇t consider the bypass flow and can＇t calculate its volume fraction, but bypass flow is critical to tundish metallurgy. And through Sahai＇s model, the calculation result of plug flow region＇s volume fraction is also not reasonable, because the model doesn＇t well describe the essence of plug flow. So these suggest that it is not reliable to apply Sahai＇s single-strand tundish model to multi-strand tundish case. Then a new model is attempted to propose in this paper for your discussion. In the new model, the standard of plotting RTD curve is definitely proposed, and relative calculation method is also proposed; and the feature of dead region is carefully studied and the model proposes a new method to calculate its volume fraction, and the calculation formula about its volume fraction can be adjustable according the actual demand; what＇s more, the new model considers the bypass flow and proposes a method to calculate its volume fraction for the first time, and then volume fraction of plug flow region, backmix flow region, dead region and bypass flow can be calculated and obtained at the same time; and this new model can better capture the deviation of reality flow pattern from ideal plug flow pattern, and reflects the feature of plug flow.
文摘Background: Risk stratification of long-term outcomes for patients undergoing Coronary artery bypass grafting has enormous potential clinical importance. Aim: To develop risk stratification models for predicting long-term outcomes following coronary artery bypass graft (CABG) surgery. Methods: We retrospectively revised the electronic medical records of 2330 patients who underwent adult Cardiac surgery between August 2016 and December 2022 at Madinah Cardiac Center, Saudi Arabia. Three hundred patients fulfilled the eligibility criteria of CABG operations with a complete follow-up period of at least 24 months, and data reporting. The collected data included patient demographics, comorbidities, laboratory data, pharmacotherapy, echocardiographic parameters, procedural details, postoperative data, in-hospital outcomes, and follow-up data. Our follow-up was depending on the clinical status (NYHA class), chest pain recurrence, medication dependence and echo follow-up. A univariate analysis was performed between each patient risk factor and the long-term outcome to determine the preoperative, operative, and postoperative factors significantly associated with each long-term outcome. Then a multivariable logistic regression analysis was performed with a stepwise, forward selection procedure. Significant (p < 0.05) risk factors were identified and were used as candidate variables in the development of a multivariable risk prediction model. Results: The incidence of all-cause mortality during hospital admission or follow-up period was 2.3%. Other long-term outcomes included all-cause recurrent hospitalization (9.8%), recurrent chest pain (2.4%), and the need for revascularization by using a stent in 5 (3.0%) patients. Thirteen (4.4%) patients suffered heart failure and they were on the maximum anti-failure medications. The model for predicting all-cause mortality included the preoperative EF ≤ 35% (AOR: 30.757, p = 0.061), the bypass time (AOR: 1.029, p = 0.003), and the duration of ventilation following the operation (AOR: 1.237, p = 0.021). The model for risk stratification of recurrent hospitalization comprised the preoperative EF ≤ 35% (AOR: 6.198, p p = 0.023), low postoperative cardiac output (AOR: 3.622, p = 0.007), and the development of postoperative atrial fibrillation (AOR: 2.787, p = 0.038). Low postoperative cardiac output was the only predictor that significantly contributed to recurrent chest pain (AOR: 11.66, p = 0.004). Finally, the model consisted of low postoperative cardiac output (AOR: 5.976, p < 0.001) and postoperative ventricular fibrillation (AOR: 4.216, p = 0.019) was significantly associated with an increased likelihood of the future need for revascularization using a stent. Conclusions: A risk prediction model was developed in a Saudi cohort for predicting all-cause mortality risk during both hospital admission and the follow-up period of at least 24 months after isolated CABG surgery. A set of models were also developed for predicting long-term risks of all-cause recurrent hospitalization, recurrent chest pain, heart failure, and the need for revascularization by using stents.
文摘目的探讨成年冠心病患者行冠状动脉旁路移植术(coronary artery bypass grafting,CABG)出院后30 d内非计划再入院的相关因素,构建风险预测模型并进行验证。方法回顾性分析2020年1月—2024年6月于南京市第一医院行单纯CABG患者的临床资料。将2020年1月—2023年8月患者纳入训练集,2023年9月—2024年6月患者纳入验证集。在训练集中,根据出院后30 d内有无非计划再入院,将患者分为再入院组和非再入院组,并比较两组临床资料,利用logistic回归分析确定非计划再入院的独立危险因素,构建风险预测模型及列线图,内部评价模型效能;并利用验证集资料作验证。结果纳入患者2460例,其中男1787例、女673例,中位年龄70(34,89)岁。训练集1932例,验证集528例。训练集中再入院组(79例)与非再入院组(1853例)患者性别、年龄、颈动脉狭窄、心肌梗死病史、术前贫血、心功能分级等差异有统计学意义(P<0.05)。术后切口愈合不良、肺部感染和新发心房颤动为再入院的主要原因。多因素l o g i s t i c回归分析显示,女性[O R=1.659,95%CI(1.022,2.692),P=0.041]、年龄[OR=1.042,95%CI(1.011,1.075),P=0.008]、颈动脉狭窄[OR=1.680,95%CI(1.130,2.496),P=0.010]、首次ICU停留时间[OR=1.359,95%CI(1.195,1.545),P<0.001]及二次入ICU[OR=4.142,95%CI(1.507,11.383),P=0.006]是非计划再入院的独立危险因素。内部评价中,曲线下面积为0.806,临床决策曲线净获益率>3%;验证集中,曲线下面积为0.732,临床决策曲线净获益率为3%~48%。结论女性、年龄、颈动脉狭窄、首次ICU停留时间及二次入ICU是单纯CABG术后出院30 d内非计划再入院的独立危险因素,构建的列线图具有良好的预测作用。
