Department of Cardiovascular Surgery, The Second Affiliated Hospital, Jiangxi Medical College, Nanchang University, Nanchang, China.
The Second Clinical Medical College of Nanchang University, Nanchang, China.
BMC Cardiovasc Disord. 2024 May 14;24(1):250. doi: 10.1186/s12872-024-03923-x.
Prolonged mechanical ventilation (PMV) is a common complication following cardiac surgery linked to unfavorable patient prognosis and increased mortality. This study aimed to search for the factors associated with the occurrence of PMV after valve surgery and to develop a risk prediction model.
The patient cohort was divided into two groups based on the presence or absence of PMV post-surgery. Comprehensive preoperative and intraoperative clinical data were collected. Univariate and multivariate logistic regression analyses were employed to identify risk factors contributing to the incidence of PMV. Based on the logistic regression results, a clinical nomogram was developed.
The study included 550 patients who underwent valve surgery, among whom 62 (11.27%) developed PMV. Multivariate logistic regression analysis revealed that age (odds ratio [OR] = 1.082, 95% confidence interval [CI] = 1.042-1.125; P < 0.000), current smokers (OR = 1.953, 95% CI = 1.007-3.787; P = 0.047), left atrial internal diameter index (OR = 1.04, 95% CI = 1.002-1.081; P = 0.041), red blood cell count (OR = 0.49, 95% CI = 0.275-0.876; P = 0.016), and aortic clamping time (OR = 1.031, 95% CI = 1.005-1.057; P < 0.017) independently influenced the occurrence of PMV. A nomogram was constructed based on these factors. In addition, a receiver operating characteristic (ROC) curve was plotted, with an area under the curve (AUC) of 0.782 and an accuracy of 0.884.
Age, current smokers, left atrial diameter index, red blood cell count, and aortic clamping time are independent risk factors for PMV in patients undergoing valve surgery. Furthermore, the nomogram based on these factors demonstrates the potential for predicting the risk of PMV in patients following valve surgery.
心脏手术后长时间机械通气（PMV）是一种常见的并发症，与患者预后不良和死亡率增加有关。本研究旨在寻找与瓣膜手术后 PMV 发生相关的因素，并建立风险预测模型。
根据术后是否发生 PMV，将患者队列分为两组。收集全面的术前和术中临床数据。采用单因素和多因素逻辑回归分析确定导致 PMV 发生的危险因素。基于逻辑回归结果，建立临床列线图。
本研究纳入了 550 例行瓣膜手术的患者，其中 62 例（11.27%）发生了 PMV。多因素逻辑回归分析显示，年龄（比值比[OR] = 1.082，95%置信区间[CI] = 1.042-1.125；P < 0.000）、当前吸烟者（OR = 1.953，95% CI = 1.007-3.787；P = 0.047）、左心房内径指数（OR = 1.04，95% CI = 1.002-1.081；P = 0.041）、红细胞计数（OR = 0.49，95% CI = 0.275-0.876；P = 0.016）和主动脉夹闭时间（OR = 1.031，95% CI = 1.005-1.057；P < 0.017）独立影响 PMV 的发生。根据这些因素构建了列线图。此外，绘制了受试者工作特征（ROC）曲线，曲线下面积（AUC）为 0.782，准确性为 0.884。
年龄、当前吸烟者、左心房直径指数、红细胞计数和主动脉夹闭时间是瓣膜手术后 PMV 的独立危险因素。此外，基于这些因素的列线图显示了预测瓣膜手术后 PMV 风险的潜力。
