摘要
目的 探讨无创正压通气(non-invasive positive pressure ventilation, NIPPV)治疗患者发生胃肠功能紊乱的危险因素,构建胃肠功能紊乱列线图预测模型,并验证其预测效果。方法 回顾性选取2019年1月-2023年1月于我院急诊ICU住院行NIPPV治疗的368例患者为研究对象,按照7∶3的比例随机分为建模集258例和验证集110例。根据患者ICU住院期间是否发生胃肠功能紊乱,将患者分为胃肠功能正常组和紊乱组。采用多因素logistic回归分析建立的胃肠功能紊乱列线图预测模型,并对该模型进行内部验证,评价其预测效能。结果 NIPPV治疗患者胃肠功能紊乱发生率为30.16%,其中以腹胀最为常见。最终纳入模型的预测变量为年龄、糖尿病、管饲、NIPPV模式、胃泌素、白蛋白、超敏C反应蛋白。建模集中,受试者工作特征曲线下面积为0.809,预测临界值为168分,敏感度为66.2%,特异度为80.7%,Hosmer-Lemeshow检验χ~2=3.949,P=0.862。验证集中,受试者工作特征曲线下面积为0.817,敏感度为67.6%,特异度为86.8%,Hosmer-Lemeshow检验χ~2=7.092,P=0.527。校正曲线均显示出良好的区分度及一致性。结论 本研究构建的NIPPV治疗患者胃肠功能紊乱的风险预警列线图模型具有较高的预测效能,可为临床ICU医护人员识别胃肠功能紊乱高危患者提供依据。
Objective To explore the risk factors for gastrointestinal dysfunction in patients treated with non-invasive positive pressure ventilation(NIPPV),andconstruct a nomogram prediction model for gastrointestinal dysfunction column chart,and verify its prediction effect.Methods A total of 368 patients hospitalized in the emergency ICU of our hospitalfrom January 2019 to January 2023 who received NIPPV treatmentwere retrospectively selected as the study objects,and randomly divided into a modeling group(258 cases)and a validation group(110 cases)according to the ratio of 7∶3.According to whether gastrointestinal disorders occurred during their ICU stay,the patients were divided into normal and disordered gastrointestinal function groups.Multi-factor logistic regression analysis was used to establish the nomogram prediction model of gastrointestinal dysfunction,and the model was internally validated to evaluate its predictive efficacy.Results The prevalence of gastrointestinal dysfunction in patients treated with NIPPV was 30.16%,with bloating being the most common.The final predictor variables included in the model were age,diabetes,feeding,NIPPV mode,gastrin,albumin,and hypersensitive C-reactive protein.In the modeling group,the area under the receiver operating curve was 0.809,and with the corresponding prediction thresholds at 168 points,the sensitivity was 66.2%,and the specificitywas 80.7%,the result ofHosmer-Lemeshow test wasχ2=3.949,P=0.862.In the validation group,the area under the receiver operating curve was 0.817,the sensitivity was 67.6%,and the specificity was 86.8%,the result ofHosmer-Lemeshow test wasχ2=7.092,P=0.527.The calibration curves all showed good discrimination and consistency.Conclusions The nomogram prediction model of gastrointestinal dysfunction in patients treated with NIPPV constructed in this study has high predictive efficacy,and can provide a basis for clinical ICU healthcare workers to identify high-riskpatients with gastrointestinal dysfunction.
作者
蒋伟康
封启明
黄佳倩
邵小平
JIANG Weikang;FENG Qiming;HUANG Jiaqian;SHAO Xiaoping(Department of Emergency Medicine,Shanghai Sixth People's Hospital,Shanghai 200233,China;Wuliqiao Street Community Health Service Center,Shanghai 200001,China)
出处
《护士进修杂志》
2024年第11期1156-1162,共7页
Journal of Nurses Training
基金
上海市第六人民医院院级科学研究基金项目(编号:院内X-4289)
上海现代护理职业教育集团特聘兼职教师项目(编号:hlzjtpgr202309)。
关键词
无创正压通气
胃肠功能紊乱
列线图
预测模型
non-invasive positive pressure ventilation
gastrointestinal dysfunction
nomogram
prediction model
