肩关节镜手术患者术中低体温预测模型的构建及验证  

Establishment and validation of a prediction equation to estimate risk of intraoperative hypothermia in patients undergoing shoulder arthroscopy

作　　者：吴晓舟[1] 魏彦姝[1] 闵玉娣 刘晓黎 Wu Xiaozhou;Wei Yanshu;Min Yudi;Liu Xiaoli(Central Operating Room,Peking University People's Hospital,Beijing 100044,China)

机构地区：[1]北京大学人民医院手术室,100044

出　　处：《中华肩肘外科电子杂志》2020年第4期335-339,共5页Chinese Journal of Shoulder and Elbow(Electronic Edition)

基　　金：北京大学人民医院研究发展基金(RDN2019-07)。

摘　　要：目的构建肩关节镜手术患者术中低体温风险预测模型并检验其预测效果.方法选取2019年1月至2020年7月北京大学人民医院261例肩关节镜手术患者为研究对象,其中2019年1月至12月为建模组(n=174),2020年1月至7月为验证组(n=87),采用单因素分析筛选变量,通过Logistic回归建立模型,并进行Hosmer-Lemeshow拟合优度检验,采用受试者操作特征曲线下面积评价模型的预测效果.结果建模组患者术中低体温发生率为56.32%(98/174),验证组为42.53%(37/87);最终模型包括3个预测因子:基础体温(OR=0.033)、麻醉时间(OR=1.002)和BMI(OR=0.845).Hosmer-Lemeshow检验P=0.377,AUC为0.858,Youden指数为0.603,灵敏度为0.735,特异度为0.868.模型验证显示正确率为83.84%.结论本研究构建的模型具有较好的预测效果,可为临床评估肩关节镜手术患者术中低体温风险提供参考.Background Inadvertent perioperative hypothermia,defined as a core body temperature lower than 36.0℃,is common in the perioperative period and may be associated with adverse effects.Shoulder arthroscopy is a well-established technique in dealing with a variety of shoulder disorders.During the operation,a large amount of irrigation fluid is required to ensure clear visibility.Considering the shoulder joint is quite close to the core body structure,the irrigation fluid temperature could adversely affect the core body temperature,resulting in hypothermia-related problems.Accurate risk assessment of individuals may help physicians identify patients at the risk of hypothermia and take preventive measures.However,there is no specific risk assessment tool for shoulder arthroscopy.Objective To establish a risk prediction model of intraoperative hypothermia in patients undergoing shoulder arthroscopy and to test its predictive effect.Methods From January 2019 to July 2020,a total of 261 patients were conveniently selected as study objects in our hospital.The patients who received shoulder arthroscopy were divided into the modeling group(January 2019 to December 2019,n=174)and the verification group(January 2020 to July 2020,n=87).Variables were screened by univariate analysis,and the model was established by Logistic regression.Hosmer-Lemeshow goodness of fit test was carried out,and the area under the receiver operator characteristic curve was used to evaluate the predictive effect of the model.Results The incidence of intraoperative hypothermia was 56.32%(98/174)in the modeling group and 42.53%(37/87)in the verification group.The ultimate model included three predictors:basal body temperature(OR=0.033),anesthesia duration(OR=1.002)and BMI(OR=0.845).Hosmer-Lemeshow test:P=0.377,AUC:0.858,Youden index:0.603,sensitivity:0.735,and specificity:0.868.The accuracy of model verification is 83.84%.Conclusion The model established in this study has a good predictive effect and can provide a reference for clinical evaluation of

关 键 词：肩关节镜 术中低体温 风险预测模型 手术室护理 

分 类 号：R687.4[医药卫生—骨科学]