The aim of this study was to figure out the predictors of early postoperative catheter-related bladder discomfort（CRBD） after urological surgery. We designed a prospective observational study in our hospital. Consec...The aim of this study was to figure out the predictors of early postoperative catheter-related bladder discomfort（CRBD） after urological surgery. We designed a prospective observational study in our hospital. Consecutive adult patients undergoing surgery under general anaesthesia or epidural anaesthesia necessitating urinary catheterization were included during a 3-month period. severity of bladder discomfort was assessed on a 4-point scale：（1） no pain,（2） mild pain（revealed only by interviewing the patient）,（3） moderate（a spontaneous complaint by the patient of a burning sensation in the urethra and/or an urge to urinate and/or sensation of urethral foreign body without any emotional agitation） and（4） severe discomfort（agitation, loud complaints and attempt to remove the bladder catheter associated with a burning sensation in the urethra）. Predictors of CRBD were identified by univariate and multivariate analysis. Totally, 116 patients were included, of which 84.5% had CRBD（mild CRBD： 40.5%; moderate or severe CRBD： 44.0%） at day 1, while 31.9% developed CRBD（mild CRBD： 29.3%; moderate or severe CRBD： 2.6%） at day 3. We evaluated 9 potential forecast factors of CRBD, and univariate Chi-square test showed male gender [OR=2.4, 95%CI（1.1–5.6）, P〈0.05], abdominal open surgery compared with transurethral surgery [OR=0.3, 95%CI（0.1–0.6）, P〈0.05], abdominal surgery compared with laparoscopic surgery [OR=3.3, 95%CI（1.2–8.9）, P〈0.05] and history of catheterization [OR=0.5, 95%CI（0.2–0.9）, P〈0.05] were independent predictors of moderate or severe CRBD in the patients after surgery. While multivariate logistic regression analysis showed that the abdominal open surgery [EXP（B）=3.074, 95%CI（1.3–7.4）, P〈0.05] and the history of catheterization [EXP（B）=2.458, 95%CI（1.1–5.9）, P〈0.05] might contribute more to the occurrence of moderate or severe CRBD. In conclusion, this observational study identified that the type of surgery and the history of catheterization might be predictive factors of moderate and severe CRBD after urological surgery.展开更多
目的:探讨中老年全身麻醉术病人苏醒期导尿管相关膀胱不适(catheter related bladder discomfort,CRBD)的预测因素,构建列线图风险预测模型,以实现临床早期管理。方法:采取便利抽样法,选取2023年1月—11月医院收治的120例中老年全身麻...目的:探讨中老年全身麻醉术病人苏醒期导尿管相关膀胱不适(catheter related bladder discomfort,CRBD)的预测因素,构建列线图风险预测模型,以实现临床早期管理。方法:采取便利抽样法,选取2023年1月—11月医院收治的120例中老年全身麻醉术病人为研究对象,使用一般资料调查表进行资料收集,按照CRBD严重程度分级标准进行现状调查,并采用Logistic回归分析确定中老年全身麻醉术病人苏醒期CRBD的独立影响因素,据此构建风险预测模型,检验模型预测效果。结果:本研究120例病人中共43例发生CRBD,发生率为35.83%。Logistic回归分析显示,性别、手术类型、导尿时机、术中使用右美托咪定、苏醒期躁动、疼痛程度均为中老年全身麻醉术病人苏醒期CRBD的独立影响因素(P<0.05)。本研究风险预测模型Hosmer⁃Lemeshow卡方检验结果为χ^(2)=7.489,P=0.794。受试者工作特征(ROC)曲线下面积(AUC)为0.816,95%CI[0.791,0.884],灵敏度为79.24%,特异度为93.74%;C⁃index为0.741,预测准确率为(5+14)/24×100%=79.17%。决策曲线分析结果显示,当概率阈值为17%~83%,利用该模型能取得更好净获益。结论:中老年全身麻醉术病人苏醒期CRBD发生率较高,本研究通过调查相关影响因素并构建风险预测模型,能有效为临床提供早期筛查和护理决策指导。展开更多
文摘The aim of this study was to figure out the predictors of early postoperative catheter-related bladder discomfort（CRBD） after urological surgery. We designed a prospective observational study in our hospital. Consecutive adult patients undergoing surgery under general anaesthesia or epidural anaesthesia necessitating urinary catheterization were included during a 3-month period. severity of bladder discomfort was assessed on a 4-point scale：（1） no pain,（2） mild pain（revealed only by interviewing the patient）,（3） moderate（a spontaneous complaint by the patient of a burning sensation in the urethra and/or an urge to urinate and/or sensation of urethral foreign body without any emotional agitation） and（4） severe discomfort（agitation, loud complaints and attempt to remove the bladder catheter associated with a burning sensation in the urethra）. Predictors of CRBD were identified by univariate and multivariate analysis. Totally, 116 patients were included, of which 84.5% had CRBD（mild CRBD： 40.5%; moderate or severe CRBD： 44.0%） at day 1, while 31.9% developed CRBD（mild CRBD： 29.3%; moderate or severe CRBD： 2.6%） at day 3. We evaluated 9 potential forecast factors of CRBD, and univariate Chi-square test showed male gender [OR=2.4, 95%CI（1.1–5.6）, P〈0.05], abdominal open surgery compared with transurethral surgery [OR=0.3, 95%CI（0.1–0.6）, P〈0.05], abdominal surgery compared with laparoscopic surgery [OR=3.3, 95%CI（1.2–8.9）, P〈0.05] and history of catheterization [OR=0.5, 95%CI（0.2–0.9）, P〈0.05] were independent predictors of moderate or severe CRBD in the patients after surgery. While multivariate logistic regression analysis showed that the abdominal open surgery [EXP（B）=3.074, 95%CI（1.3–7.4）, P〈0.05] and the history of catheterization [EXP（B）=2.458, 95%CI（1.1–5.9）, P〈0.05] might contribute more to the occurrence of moderate or severe CRBD. In conclusion, this observational study identified that the type of surgery and the history of catheterization might be predictive factors of moderate and severe CRBD after urological surgery.
文摘目的:探讨中老年全身麻醉术病人苏醒期导尿管相关膀胱不适(catheter related bladder discomfort,CRBD)的预测因素,构建列线图风险预测模型,以实现临床早期管理。方法:采取便利抽样法,选取2023年1月—11月医院收治的120例中老年全身麻醉术病人为研究对象,使用一般资料调查表进行资料收集,按照CRBD严重程度分级标准进行现状调查,并采用Logistic回归分析确定中老年全身麻醉术病人苏醒期CRBD的独立影响因素,据此构建风险预测模型,检验模型预测效果。结果:本研究120例病人中共43例发生CRBD,发生率为35.83%。Logistic回归分析显示,性别、手术类型、导尿时机、术中使用右美托咪定、苏醒期躁动、疼痛程度均为中老年全身麻醉术病人苏醒期CRBD的独立影响因素(P<0.05)。本研究风险预测模型Hosmer⁃Lemeshow卡方检验结果为χ^(2)=7.489,P=0.794。受试者工作特征(ROC)曲线下面积(AUC)为0.816,95%CI[0.791,0.884],灵敏度为79.24%,特异度为93.74%;C⁃index为0.741,预测准确率为(5+14)/24×100%=79.17%。决策曲线分析结果显示,当概率阈值为17%~83%,利用该模型能取得更好净获益。结论:中老年全身麻醉术病人苏醒期CRBD发生率较高,本研究通过调查相关影响因素并构建风险预测模型,能有效为临床提供早期筛查和护理决策指导。
