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构建并验证老年全髋关节置换术患者术中低体温风险预测模型。

Construction and validation of a risk prediction model for intraoperative hypothermia in elderly patients undergoing total hip arthroplasty.

机构信息

Department of Anesthesiology and SICU, School of Medicine, Xinhua Hospital, Shanghai Jiao Tong University, Kongjiang Road 1665, Shanghai, 200092, China.

Department of Psychogeriatric, School of Medicine, Shanghai Mental Health Center, Shanghai Jiao Tong University, South Wanping Road 600, Shanghai, 200030, China.

出版信息

Aging Clin Exp Res. 2023 Oct;35(10):2127-2136. doi: 10.1007/s40520-023-02500-0. Epub 2023 Jul 25.

Abstract

AIMS

To construct and validate an intraoperative hypothermia risk prediction model for elderly patients undergoing total hip arthroplasty (THA).

METHODS

We collected data from 718 patients undergoing THA in a tertiary hospital from January 2021 to December 2022. Of these patients, 512 were assigned to the modeling group from January 2021 to April 2022, and 206 participants were assigned to the validation group from May 2022 to December 2022. A logistic regression analysis was performed to construct the model. The area under the curve (AUC) was used to test the model's predictive ability.

RESULTS

The incidence rate of intraoperative hypothermia was 51.67%. The risk factors entered into the risk prediction model were age, preoperative hemoglobin level, intraoperative blood loss, postoperative hemoglobin level, and postoperative systolic blood pressure. The model was constructed as follows: logit (P) = - 10.118 + 0.174 × age + 1.366 × 1 (preoperative hemoglobin level) + 0.555 × 1 (postoperative hemoglobin level) + 0.009 × 1 (intraoperative blood loss) + 0.066 × 1 (postoperative systolic blood pressure). Using the Hosmer-Lemeshow test, the P value was 0.676 (AUC, 0.867). The Youden index, sensitivity, and specificity were 0.602, 0.790, and 0.812, respectively. The incidence rates of intraoperative hypothermia in the modeling and validation groups were 53.15% and 48.06%, respectively. The correct practical application rate was 89.81%. This model had good application potential.

CONCLUSIONS

This risk prediction model has good predictive value and can accurately predict the occurrence of intraoperative hypothermia in patients who undergo THA, which provides reliable guidance for clinical work and has good clinical application value.

摘要

目的

构建并验证一个用于接受全髋关节置换术(THA)的老年患者术中低体温风险的预测模型。

方法

我们收集了 2021 年 1 月至 2022 年 12 月在一家三级医院接受 THA 的 718 名患者的数据。其中,512 名患者被分配到 2021 年 1 月至 4 月的建模组,206 名患者被分配到 2022 年 5 月至 12 月的验证组。使用逻辑回归分析构建模型。使用曲线下面积(AUC)来检验模型的预测能力。

结果

术中低体温的发生率为 51.67%。进入风险预测模型的危险因素有年龄、术前血红蛋白水平、术中失血量、术后血红蛋白水平和术后收缩压。模型构建如下:logit(P)=-10.118+0.174×年龄+1.366×1(术前血红蛋白水平)+0.555×1(术后血红蛋白水平)+0.009×1(术中失血量)+0.066×1(术后收缩压)。使用 Hosmer-Lemeshow 检验,P 值为 0.676(AUC,0.867)。约登指数、灵敏度和特异度分别为 0.602、0.790 和 0.812。建模组和验证组术中低体温的发生率分别为 53.15%和 48.06%。正确实用率为 89.81%。该模型具有良好的应用潜力。

结论

该风险预测模型具有良好的预测价值,能够准确预测接受 THA 的患者术中低体温的发生,为临床工作提供可靠指导,具有良好的临床应用价值。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/fe06/10520156/b5a9b38bf536/40520_2023_2500_Fig1_HTML.jpg

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