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儿童咽部鱼骨异物的危险因素分析及模型构建

Risk factor analysis and model construction for fish bone foreign body in children's pharynx.

机构信息

Department of Otorhinolaryngology, Children's Hospital of Nanjing Medical University, Jiangsu, China.

Department of Otorhinolaryngology, Children's Hospital of Nanjing Medical University, Jiangsu, China.

出版信息

Am J Otolaryngol. 2024 Sep-Oct;45(5):104364. doi: 10.1016/j.amjoto.2024.104364. Epub 2024 May 8.

Abstract

OBJECTIVES

This study aimed to assess the risk factors for predicting the presence of fish bone foreign bodies and to develop a risk prediction model.

METHODS

Data of 1405 children who underwent video-guided laryngoscope for suspected fish bone foreign body ingestion were retrospectively analyzed. Multi-factor logistic regression analyses were performed to analyze the risk factors for the presence of fish bone foreign body in patients, and a risk prediction model was established based on the results of the logistic regression analysis.

RESULTS

The results of the statistical analysis showed the presence of an ulcerated surface increased the risk of having a fishbone foreign body in the pharynx by approximately 55.36-fold (95 % confidence interval (CI): 15.78-194.24), followed by a clear chief complaint site, which increased the risk of having a fishbone foreign body in the pharynx by approximately 7.963-fold (95 % CI: 4.820-13.15), and a tingling sensation, which increased the risk of having a fishbone foreign body by approximately 7-fold (95 % CI: 3.483, 14.233). A clinical prediction model (nomogram) was developed and its validation was performed using receiver operating characteristic (ROC) curve analysis, in which an area under the curve (AUC) value of 0.808 indicated that the model had a great prediction capability.

CONCLUSION

The predictive capability of a logistic regression model for the detection of fish bone foreign bodies following ingestion is significant. Clinicians can concentrate on monitoring these risk factors and implementing appropriate interventions to reduce the risks of patients presenting with fish bone foreign bodies.

摘要

目的

本研究旨在评估预测鱼骨异物存在的危险因素,并建立风险预测模型。

方法

回顾性分析 1405 例因疑似鱼骨异物摄入而行视频喉镜检查的患儿资料。采用多因素 logistic 回归分析患者存在鱼骨异物的危险因素,并基于 logistic 回归分析结果建立风险预测模型。

结果

统计分析结果显示,表面溃疡使咽部长有鱼骨异物的风险增加约 55.36 倍(95%置信区间:15.78-194.24),其次是明确的主要症状部位,使咽部长有鱼骨异物的风险增加约 7.963 倍(95%置信区间:4.820-13.15),刺痛感使咽部长有鱼骨异物的风险增加约 7 倍(95%置信区间:3.483-14.233)。建立了一个临床预测模型(列线图),并通过接收者操作特征(ROC)曲线分析对其进行了验证,曲线下面积(AUC)值为 0.808,表明该模型具有很好的预测能力。

结论

logistic 回归模型对预测食入鱼骨后的异物存在具有显著的预测能力。临床医生可以集中监测这些危险因素,并采取适当的干预措施,降低患者出现鱼骨异物的风险。

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