Yang Yi, Li Jianquan, You Linlin, Jiang Zhixia
Department of Critical Care Medicine, Guizhou Provincial People's Hospital, Guiyang 550000, Guizhou, China.
Department of Nursing, the Second Affiliated Hospital of Zunyi Medical University, Zunyi 563000, Guizhou, China.
Zhonghua Wei Zhong Bing Ji Jiu Yi Xue. 2024 Aug;36(8):853-859. doi: 10.3760/cma.j.cn121430-20231227-01123.
To construct Risk factor assessment table for hyperoxemia in patients after cardiopulmonary bypass heart surgery based on Delphi method, providing a basis for early prediction and assessment of the risk of hyperoxemia in patients after cardiac surgery.
A research team was established. Based on the characteristics of extracorporeal circulation cardiac surgery, the Chinese and English literature published by each database until October 2022 was retrieved and the opinions of relevant professional clinicians were combined to screen the risk factors of hyperoxemia in patients after cardiopulmonary bypass heart surgery, and the preliminary draft of the Risk factor assessment table for hyperoxemia in patients after cardiopulmonary bypass heart surgery was drawn up. The Delphi method was used to conduct two rounds of expert letter consultation to supplement and improve the initial draft and finally established the final draft of the Risk factor assessment table for hyperoxemia in patients after cardiopulmonary bypass heart surgery.
The preliminary draft of the Risk factor assessment table for hyperoxemia in patients after cardiopulmonary bypass heart surgery was constructed according to the literature review and the opinions of relevant professional clinicians, which contained 4 dimensions and 21 items. A total of 14 experts were consulted by letter, including 5 senior titles and 9 associate senior titles. Six of them major in critical care and the other eight major in cardiovascular surgery. The effective response rates for the two rounds of questionnaire surveys were 100% and 85.71%, expert familiarity levels were 0.81 and 0.80, judgment coefficients were 0.94 and 0.92, respectively. Expert authority coefficients were both 0.86. Coefficients of variation for the importance and feasibility items in the two rounds ranged from 0.13 to 0.32 and 0.11 to 0.32, 0.06 to 0.26 and 0.06 to 0.35, respectively. The Kendall's W for importance and feasibility in the two rounds were 0.264 and 0.162, and 0.258 and 0.144 respectively, indicating statistically significant (all P < 0.05). After two rounds of expert consultations, a comprehensive evaluation and selection process resulted in the final establishment of the Risk factor assessment table for hyperoxemia in patients after cardiopulmonary bypass heart surgery, consisting of 4 dimensions and 23 items, which included general data, past history, operation-related data and postoperative data.
The Risk factor assessment table for hyperoxemia in patients after cardiopulmonary bypass heart surgery based on the Delphi method is highly scientific and feasible, which can provide reference for clinical assessments of the risk of hyperoxemia in such patients.
基于德尔菲法构建体外循环心脏术后患者高氧血症危险因素评估表，为心脏术后患者高氧血症风险的早期预测和评估提供依据。
成立研究团队。根据体外循环心脏手术特点，检索截至2022年10月各数据库发表的中英文文献，并结合相关专业临床医生意见，筛选体外循环心脏术后患者高氧血症的危险因素，拟定体外循环心脏术后患者高氧血症危险因素评估表初稿。采用德尔菲法进行两轮专家函询，对初稿进行补充完善，最终确立体外循环心脏术后患者高氧血症危险因素评估表终稿。
根据文献回顾及相关专业临床医生意见构建了体外循环心脏术后患者高氧血症危险因素评估表初稿，包含4个维度21项。共函询14名专家，其中正高职称5名，副高职称9名。其中6名重症医学专业，8名心血管外科专业。两轮问卷调查有效回收率分别为100%和85.71%，专家熟悉程度分别为0.81和0.80，判断系数分别为0.94和0.92，专家权威系数均为0.86。两轮重要性和可行性条目的变异系数分别为0.13～0.32和0.11～0.32，0.06～0.26和0.06～0.35。两轮重要性和可行性的肯德尔W系数分别为0.264和0.162，0.258和0.144，差异有统计学意义（均P<0.05）。经过两轮专家咨询，综合评估筛选后最终确立体外循环心脏术后患者高氧血症危险因素评估表，由4个维度23项组成，包括一般资料、既往史、手术相关资料及术后资料。
基于德尔菲法构建的体外循环心脏术后患者高氧血症危险因素评估表具有较高的科学性和可行性，可为临床评估此类患者高氧血症风险提供参考。
