摘要
目的探讨普外科术中低体温发生的风险因素,构建并验证术中低体温发生的风险预测模型。方法选取2020年12月至2022年12月在本院接受普外科手术的117例患者作为观察对象。收集患者临床资料,根据患者术中是否发生低体温将其分为发生低体温组(A组)和未发生低体温组(B组)。Logistic回归分析影响患者普外科术中发生低体温的危险因素,并建立风险预测模型,受试者工作特征曲线(ROC)检测该模型的预测效能。结果117例患者中发生低体温31例(26.49%),未发生低体温86例(73.50%)。两组患者在年龄、体重指数、手术方式、ASA分级、术中输液量、手术室温、手术时间等方面比较,差异具有统计学意义(P<0.05)。Logistic回归分析结果显示,年龄≥65岁、术中输液量≥1000 mL、麻醉时间≥4 h、手术室温<23℃是普外科术中发生低体温的危险因素(P<0.05)。独立危险因素纳入Logistic回归分析并建立预测模型,模型预测概率P=1/[1+e(-1.020+0.874)×(年龄)+1.114×(术中输液量)+1.556×(手术室温)+1.453×(麻醉时间)]。ROC曲线检验该模型预测效能,结果显示ROC曲线下面积(AUC)=0.754(P<0.05);Hosmer-Lemeshow拟合优度检验显示,χ^(2)=1.001,P=0.998。结论患者年龄、术中输液量、麻醉时间、手术室温是普外科患者术中发生低体温的独立危险因素,Logistic风险预测模型拟合效度好,具有较高预测价值。
Objective To explore the risk factors of intraoperative hypothermia in generalsurgery,constructand verify the risk prediction model of intraoperative hypothermia.Methods A total of 117 patients underwentgeneral surgery in the hospital were enrolled as the observation objects from December 2020 to December 2022.The clinical data of the patients were collected.According to presence or absence of intraoperative hypothermia,thepatients were divided into hypothermia group(group A)and non-hypothermia group(group B).The risk factors of intraoperative hypothermia were analyzed byLogistic regression analysis,and the risk prediction model was constructed.The predictive efficiency of the model was detected by receiver operating characteristic(ROC)curves.Results Among the 117 patients,there were 31(26.49%)cases with hypothermia and 86(73.50%)cases without.There were significant differences in age,body mass index,ASA grading,modus operandi,intraoperative infusion volume,operating room temperature and operation time between the 2 groups(P<0.05).The results of Logistic regression analysis showed that age≥65 years,intraoperative infusion volume≥1000 mL,anesthesia time≥4 h and operating room temperature<23℃were risk factors of hypothermia in general surgery(P<0.05).The prediction model was as follow:P=1/[1+e^((-1.020+0.874×(age)+1.114×(intraoperative infusion volume)+1.556×(operating room temperature)+1.453×(anesthesia time))].The area under the curve(AUC)of the prediction model by ROC curves was 0.754(P<0.05).The results of Hosmer-Lemeshow goodness of fit test were as follows:χ^(2)=1.001,P=0.998.Conclusion Age of patients,intraoperative infusion volume,anesthesia time and operating room temperature are independent risk factors of hypothermia in general surgery.Logistic risk prediction model has good fitting degree and high predictive value.
作者
方丹
施静婧
FANG Dan;SHI Jingjing(Operating Room,Chongming Branch Affiliated to Shanghai Health Medical College,Shanghai 202150,China)
出处
《新疆医科大学学报》
CAS
2024年第1期98-102,108,共6页
Journal of Xinjiang Medical University
基金
上海市科技计划项目(19Y11392801)。
