Department of Emergency, Ganzhou People's Hospital, Ganzhou City, Jiangxi Province, 341000, China.
Department of Nephrology, Ganzhou People's Hospital, Ganzhou City, Jiangxi Province, 341000, China.
J Cardiothorac Surg. 2024 Sep 5;19(1):516. doi: 10.1186/s13019-024-03017-x.
To analyze the influencing factors of postoperative thrombocytopenia in critically ill patients with heart disease and construct a nomogram prediction model.
From October 2022 to October 2023, 319 critically ill patients with heart disease who visited our hospital were collected and separated into postoperative thrombocytopenia group (n = 142) and no postoperative thrombocytopenia group (n = 177) based on their postoperative thrombocytopenia, Logistic regression analysis was applied to screen risk factors for postoperative thrombocytopenia in critically ill patients with heart disease; R software was applied to construct a nomogram for predicting postoperative thrombocytopenia in critically ill patients with heart disease, and ROC curves, calibration curves, and Hosmer-Lemeshow goodness of fit tests were applied to evaluate nomogram.
A total of 142 out of 319 critically ill patients had postoperative thrombocytopenia, accounting for 44.51%. Logistic regression analysis showed that gender (95% CI 1.607-4.402, P = 0.000), age ≥ 60 years (95% CI 1.380-3.697, P = 0.001), preoperative antiplatelet therapy (95% CI 1.254-3.420, P = 0.004), and extracorporeal circulation time > 120 min (95% CI 1.681-4.652, P = 0.000) were independent risk factors for postoperative thrombocytopenia in critically ill patients with heart disease. The area under the ROC curve was 0.719 (95% CI: 0.663-0.774). The slope of the calibration curve was close to 1, and the Hosmer-Lemeshow goodness of fit test was χ = 6.422, P = 0.491.
Postoperative thrombocytopenia in critically ill patients with heart disease is influenced by gender, age ≥ 60 years, preoperative antiplatelet therapy, and extracorporeal circulation time > 120 min. A nomogram established based on above multiple independent risk factors provides a method for clinical prediction of the risk of postoperative thrombocytopenia in critically ill patients with heart disease.
分析影响心脏病危重症患者术后血小板减少症的因素，并构建列线图预测模型。
收集 2022 年 10 月至 2023 年 10 月期间我院 319 例心脏病危重症患者，根据术后血小板减少症分为术后血小板减少症组（n=142）和无术后血小板减少症组（n=177），应用 Logistic 回归分析筛选心脏病危重症患者术后血小板减少症的危险因素；应用 R 软件构建心脏病危重症患者术后血小板减少症预测列线图，并应用 ROC 曲线、校准曲线和 Hosmer-Lemeshow 拟合优度检验评估列线图。
319 例心脏病危重症患者中，术后血小板减少症 142 例（44.51%）。Logistic 回归分析显示，性别（95%CI：1.607-4.402，P=0.000）、年龄≥60 岁（95%CI：1.380-3.697，P=0.001）、术前抗血小板治疗（95%CI：1.254-3.420，P=0.004）和体外循环时间>120 min（95%CI：1.681-4.652，P=0.000）是心脏病危重症患者术后血小板减少症的独立危险因素。ROC 曲线下面积为 0.719（95%CI：0.663-0.774）。校准曲线的斜率接近 1，Hosmer-Lemeshow 拟合优度检验χ²=6.422，P=0.491。
心脏病危重症患者术后血小板减少症受性别、年龄≥60 岁、术前抗血小板治疗和体外循环时间>120 min 的影响。基于上述多个独立危险因素建立的列线图为预测心脏病危重症患者术后血小板减少症的风险提供了一种方法。
