Objective:This study aimed to explore the risk factors and outcomes of hypokalemia during the recovery period from anesthesia in the gynecological population.Methods:This retrospective cohort study included 208 patien...Objective:This study aimed to explore the risk factors and outcomes of hypokalemia during the recovery period from anesthesia in the gynecological population.Methods:This retrospective cohort study included 208 patients who underwent gynecological surgery at our institution between January 2021 and March 2022.Data were collected for each patient,including demographics,disease status,surgical data,and clinical information.Preoperative bowel preparation,postoperative gastrointestinal function,and electrolyte levels were compared between the two groups using propensity score matching(PSM).Results:The incidence of hypokalemia(serum potassium level<3.5 mmol/L)during the recovery period from anesthesia was approximately 43.75%.After PSM,oral laxative use(96.4%vs.82.4%,P=0.005),the number of general enemas(P=0.014),and the rate of≥2 general enemas(92.9%vs.77.8%,P=0.004)were identified as risk factors for hypokalemia,which was accompanied by decreased PaCO_(2) and hypocalcemia.There were no significant differences in postoperative gastrointestinal outcomes,such as the time to first flatus or feces,the I-FEED score(a scoring system was created to evaluate impaired postoperative gastrointestinal function),or postoperative recovery outcomes,between the hypokalemia group and the normal serum potassium group.Conclusion:Hypokalemia during postanesthesia recovery period occurred in 43.75%of gynecological patients,which resulted from preoperative mechanical bowel preparation;however,it did not directly affect clinical outcomes,including postoperative gastrointestinal function,postoperative complications,and length of hospital stay.展开更多
目的构建全麻腹腔镜胆囊切除术(laparoscopic cholecystectomy,LC)患者麻醉恢复室(postanesthesia care unit,PACU)滞留预测模型,为PACU管理提供参考。方法选取2023年1月至2024年11月在绵竹市人民医院行全麻LC的患者为研究对象,收集患...目的构建全麻腹腔镜胆囊切除术(laparoscopic cholecystectomy,LC)患者麻醉恢复室(postanesthesia care unit,PACU)滞留预测模型,为PACU管理提供参考。方法选取2023年1月至2024年11月在绵竹市人民医院行全麻LC的患者为研究对象,收集患者术前、术中和PACU期间临床资料,根据PACU停留时间是否超过1 h分为PACU滞留组和非滞留组。通过Lasso回归筛选变量后使用Logistic回归构建预测模型并绘制列线图。采用Bootstrap法重抽样1000次进行内部验证。采用受试者工作特征曲线及其曲线下面积(AUC)、Hosmer-Lemeshow拟合优度检验、校准曲线、临床决策曲线、临床影响曲线分别评价预测模型的区分度、校准度、临床适用性和有效性。结果共纳入600例LC患者,104例发生PACU滞留。Lasso回归和Logistic回归分析显示,钾离子(K+)浓度、气管拔管时间、苏醒期躁动、PACU期间恶心呕吐是PACU发生滞留的影响因素。预测模型的AUC为0.803[95%CI(0.755,0.850)],Hosmer-Lemeshow拟合优度检验结果显示模型与理想模型差异无统计学意义(χ^(2)=1.660,P=0.572),基于Bootstrap重抽样1000次的结果显示,AUC为0.803[95%CI(0.756,0.853)];校准曲线显示预测概率与实际发生概率基本拟合;临床决策曲线显示,预测概率的阈值在0.00~0.68范围时,根据模型的预测概率进行干预的临床净收益高于对所有人不进行干预和对所有人进行干预;临床影响曲线显示,当预测概率的阈值大于0.30后,每1000人中模型预测的PACU滞留人数和实际发生的PACU滞留人数出现重叠匹配。结论K+浓度、气管拔管时间、苏醒期躁动、PACU期间恶心呕吐是LC患者PACU发生滞留的影响因素,基于这些因素构建的预测模型区分度、校准度、临床适用性和有效性较好,可为LC术后PACU滞留高风险患者的识别提供参考。展开更多
文摘Objective:This study aimed to explore the risk factors and outcomes of hypokalemia during the recovery period from anesthesia in the gynecological population.Methods:This retrospective cohort study included 208 patients who underwent gynecological surgery at our institution between January 2021 and March 2022.Data were collected for each patient,including demographics,disease status,surgical data,and clinical information.Preoperative bowel preparation,postoperative gastrointestinal function,and electrolyte levels were compared between the two groups using propensity score matching(PSM).Results:The incidence of hypokalemia(serum potassium level<3.5 mmol/L)during the recovery period from anesthesia was approximately 43.75%.After PSM,oral laxative use(96.4%vs.82.4%,P=0.005),the number of general enemas(P=0.014),and the rate of≥2 general enemas(92.9%vs.77.8%,P=0.004)were identified as risk factors for hypokalemia,which was accompanied by decreased PaCO_(2) and hypocalcemia.There were no significant differences in postoperative gastrointestinal outcomes,such as the time to first flatus or feces,the I-FEED score(a scoring system was created to evaluate impaired postoperative gastrointestinal function),or postoperative recovery outcomes,between the hypokalemia group and the normal serum potassium group.Conclusion:Hypokalemia during postanesthesia recovery period occurred in 43.75%of gynecological patients,which resulted from preoperative mechanical bowel preparation;however,it did not directly affect clinical outcomes,including postoperative gastrointestinal function,postoperative complications,and length of hospital stay.
文摘目的构建全麻腹腔镜胆囊切除术(laparoscopic cholecystectomy,LC)患者麻醉恢复室(postanesthesia care unit,PACU)滞留预测模型,为PACU管理提供参考。方法选取2023年1月至2024年11月在绵竹市人民医院行全麻LC的患者为研究对象,收集患者术前、术中和PACU期间临床资料,根据PACU停留时间是否超过1 h分为PACU滞留组和非滞留组。通过Lasso回归筛选变量后使用Logistic回归构建预测模型并绘制列线图。采用Bootstrap法重抽样1000次进行内部验证。采用受试者工作特征曲线及其曲线下面积(AUC)、Hosmer-Lemeshow拟合优度检验、校准曲线、临床决策曲线、临床影响曲线分别评价预测模型的区分度、校准度、临床适用性和有效性。结果共纳入600例LC患者,104例发生PACU滞留。Lasso回归和Logistic回归分析显示,钾离子(K+)浓度、气管拔管时间、苏醒期躁动、PACU期间恶心呕吐是PACU发生滞留的影响因素。预测模型的AUC为0.803[95%CI(0.755,0.850)],Hosmer-Lemeshow拟合优度检验结果显示模型与理想模型差异无统计学意义(χ^(2)=1.660,P=0.572),基于Bootstrap重抽样1000次的结果显示,AUC为0.803[95%CI(0.756,0.853)];校准曲线显示预测概率与实际发生概率基本拟合;临床决策曲线显示,预测概率的阈值在0.00~0.68范围时,根据模型的预测概率进行干预的临床净收益高于对所有人不进行干预和对所有人进行干预;临床影响曲线显示,当预测概率的阈值大于0.30后,每1000人中模型预测的PACU滞留人数和实际发生的PACU滞留人数出现重叠匹配。结论K+浓度、气管拔管时间、苏醒期躁动、PACU期间恶心呕吐是LC患者PACU发生滞留的影响因素,基于这些因素构建的预测模型区分度、校准度、临床适用性和有效性较好,可为LC术后PACU滞留高风险患者的识别提供参考。
