| 体外循环心脏术后并发压力性损伤预测模型的建立 |
| |
| 引用本文： | 樊小倩,孙晴,仲怀凤,陈晴晴,陆真.体外循环心脏术后并发压力性损伤预测模型的建立[J].蚌埠医学院学报,2022,47(12):1752-1755. |
| |
| 作者姓名： | 樊小倩 孙晴 仲怀凤 陈晴晴 陆真 |
| |
| 作者单位： | 南京医科大学第一附属医院, 江苏省人民医院 心脏大血管外科监护, 江苏 南京 210000 |
| |
| 摘 要： | 目的构建体外循环心脏术后并发压力性损伤的预测模型。方法选取543例行体外循环心脏手术的病人作为研究对象，依据压力性损伤发生情况分为压力性损伤组（n=164）和非压力性损伤组（n=379），使用单因素和多因素logistic回归分析体外循环心脏术后并发压力性损伤的危险因素，并据此建立列线图预测模型。结果单因素分析显示:2组病人不同年龄、贫血、前白蛋白水平、术中最低体温、体外循环时间和手术时间资料间差异均有统计学意义（P < 0.01）。多因素logistic回归分析显示:年龄≥60岁、贫血、前白蛋白水平 < 280mg/L、体外循环时间≥100min和手术时间≥4 h是体外循环心脏术后并发压力性损伤的独立危险因素（P < 0.05~P < 0.01）。列线图模型验证结果显示:C-index为0.714，校准曲线趋近于理想曲线，ROC曲线的AUC为0.702（95%CI:0.681~0.727），在10%~70%范围内，列线图模型净获益。结论年龄≥60岁、贫血、前白蛋白水平 < 280mg/L、体外循环时间≥100min和手术时间≥4h会增加体外循环心脏术后并发压力性损伤的风险，根据危险因素构建的列线图模型能有效预测体外循环心脏术后并发压力性损伤的风险。
|
| 关 键 词： | 体外循环 心脏手术 压力性损伤 危险因素 列线图 |
| 收稿时间： | 2022-03-22 |
Establishment of prediction model of stress injury after cardiopulmonary bypass |
| |
| Affiliation: | Cardiac and Great Vessel Surgical Monitoring, Jiangsu Provincial People's Hospital, The First Affiliated Hospital of Nanjing Medical University, Nanjing Jiangsu 210000, China |
| |
| Abstract: | ObjectiveTo establish a prediction model of stress injury after cardiopulmonary bypass.MethodsA total of 543 patients undergoing cardiopulmonary bypass heart surgery were selected as the research objects.According to the occurrence of pressure injury, they were divided into pressure injury group (n=164) and non-pressure injury group (n=379).The risk factors of pressure injury after cardiopulmonary bypass heart surgery were analyzed by univariate and multivariate logistic regression, and the nomogram prediction model was established.ResultsUnivariate analysis showed that there were significant differences between the two groups in age, anemia, prealbumin level, minimum intraoperative temperature, duration of cardiopulmonary bypass and operation duration (P < 0.01).Multivariate logistic regression analysis showed that age ≥ 60 years old, anemia, prealbumin level < 280 mg/L, duration of cardiopulmonary bypass ≥ 100 min and operation duration ≥ 4 h were independent risk factors for stress injury after cardiopulmonary bypass (P < 0.05 to P < 0.01).The validation results of nomogram model showed that the C-index was 0.714, the calibration curve was close to the ideal curve, and the AUC of ROC curve was 0.702(95%CI: 0.681-0.727).In the range of 10%-70%, the nomogram model had a net benefit.ConclusionsAge ≥ 60 years old, anemia, prealbumin level < 280 mg/L, duration of cardiopulmonary bypass ≥ 100 min and operation duration ≥ 4 h will increase the risk of stress injury after cardiopulmonary bypass.The nomogram model constructed according to risk factors can effectively predict the risk of stress injury after cardiopulmonary bypass. |
| |
| Keywords: | |
|
| 点击此处可从《蚌埠医学院学报》浏览原始摘要信息 |
|
点击此处可从《蚌埠医学院学报》下载全文 |
|
