全麻苏醒期患儿躁动风险预测模型的建立与验证
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男,本科,护师

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Establishment and validation of a prediction model for emergence agitation after general anesthesia in children
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    目的 建立与验证全麻苏醒期患儿躁动风险列线图预测模型,为识别躁动高风险患儿提供评估工具。 方法 收集全麻手术的1~6岁患儿651例,随机分为建模组(n=459)和验证组(n=192),利用多因素logistic回归分析确定建模组全麻苏醒期患儿躁动的危险因素,构建列线图预测模型,分别使用建模组和验证组数据集对模型进行验证。 结果 苏醒期发生躁动160例(建模组113例,验证组47例),躁动发生率24.58%。多因素logistic回归显示,年龄、手术科室、身体约束、麻醉方式、镇痛治疗、留置尿管是全麻苏醒期患儿躁动的影响因素(均P<0.05)。基于6个危险因素构建列线图预测模型,模型验证的校正曲线显示模型准确度良好,建模组ROC曲线下面积为0.767,验证组为0.827。 结论 全麻苏醒期患儿躁动风险列线图预测模型具有良好的准确度和区分度,可为临床筛查术后躁动高危患儿提供评估工具。

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    Objective To establish and verify a nomogram model for predicting the risk of emergence agitation in children after general anesthesia and provide a clinical assessment tool for the identification of children at high risk of agitation. Methods A total of 651 children aged 1-6 years receiving surgery under general anesthesia were enrolled and randomly divided into a derivative group (n=459) and a validation group (n=192).Based on multivariate regression analysis, we analyzed the independent predictors of emergence agitation after general anesthesia in children, and built a nomogram prediction model, which were further tested by using the 2 groups′ data. Results A total of 160 cases (113 in the derivative group and 47 in the validation group) were found to have emergence agitation, and emergence agitation rate was 24.58%.Multivariate logistic regression results showed that age, surgery departments, physical restraint, anesthesia method, analgesia therapy, and indwelling urethral catheter were predictors of emergence agitation after general anesthesia in children (all P<0.05).A nomogram prediction model was constructed based on the predictors mentioned above.The calibration curves showed that the accuracy of the model was good.ROC curve analysis showed that AUC value was 0.767 in the derivative group, and 0.827 in the validation group. Conclusion The nomogram model for predicting the risk of emergence agitation in children after general anesthesia has good accuracy and discrimination, and can provide an evaluation tool for clinical screening of high-risk children.

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张硕,王施杭,王越,那傲.全麻苏醒期患儿躁动风险预测模型的建立与验证[J].护理学杂志,2023,28(11):1-4+9

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  • 收稿日期:2023-01-13
  • 最后修改日期:2023-03-15
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  • 在线发布日期: 2024-01-13