老年前列腺增生病人行经尿道前列腺电切术后谵妄风险预测模型的构建与验证  

Construction and validation of the risk prediction model of delirium after transurethral resection of the prostate in elderly patients with prostatic hyperplasia

作　　者：聂芳[1] 胡爱玲[2] 冯锦芳[1] 陈晓霞[1] 谭秋华[1] 黎艳超[1] NIE Fang;HU Ailing;FENG Jinfang;CHEN Xiaoxia;TAN Qiuhua;LI Yanchao(Guangdong Province Zhongshan City People's Hospital,Guangdong 528403 China)

机构地区：[1]广东省中山市人民医院,广东528403 [2]中山大学附属第三医院

出　　处：《护理研究》2021年第24期4343-4350,共8页Chinese Nursing Research

基　　金：中山市人民医院2020年科研基金立项课题,编号:2020124。

摘　　要：目的:探讨老年前列腺增生病人行经尿道前列腺电切术后谵妄的危险因素,建立术后谵妄风险预测模型并对模型的灵敏度和特异度进行验证,便于筛选术后谵妄高危人群。方法:采用便利取样法选取2019年3月—2020年6月300例老年前列腺增生病人为研究对象,依据术后住院期间是否发生谵妄分为谵妄组(n=44)和非谵妄组(n=256),分析发生术后谵妄的危险因素,采用多因素Logistic回归构建谵妄风险预测模型,收集50例病人临床资料进行模型验证。结果:300例老年病人经尿道前列腺电切术后44例发生谵妄,发生率为14.67%,术后谵妄独立危险因素有年龄、输血、肺部感染;通过Lasso回归筛选出年龄、输血、肺部感染作为重要变量构建风险预测模型,构建的谵妄风险预测模型Y=-7.326+0.066×年龄+2.056×输血+1.103×肺部感染,受试者工作特征(ROC)曲线下面积为0.813[95%CI(0.748,0.879)],灵敏度为0.886,特异度为0.638,Youden指数为-2.475。结论:年龄每增加1岁,老年男性经尿道前列腺电切术后谵妄风险增加1.069倍;有输血病人谵妄风险是没有输血病人的7.812倍,有肺部感染病人谵妄风险是没有肺部感染的3.013倍。该模型预测效果良好,可为医护人员对经尿道前列腺电切术后谵妄高风险病人及时采取预防性措施提供参考。Objective:To investigate the risk factors of postoperative delirium in elderly patients with hyperplasia of prostate after transurethral resection of the prostate,establish a risk prediction model of postoperative delirium,and verify the sensitivity and specificity of the model,so as to facilitate the screening of postoperative delirium high-risk population.Methods:Convenience sampling method was used to select300 elderly patients with hyperplasia of prostate from March 2019 to June 2020 as the research subjects.According to whether delirium occurred during postoperative hospitalization,they were divided into delirium group(n=44)and non-delirium group(n=256),and the risk factors of postoperative delirium were analyzed.Multivariate Logistic regression was used to construct a risk prediction model for delirium,and clinical data of 50 patients were collected for model validation.Results:Postoperative delirium occurred in 44 of 300 elderly patients after transurethral resection of prostate,the incidence rate was 14.67%.The independent risk factors of postoperative delirium were age,blood transfusion and pulmonary infection.Age,blood transfusion and pulmonary infection were significant variables by analyzing of Lasso regression,which were used to construct the risk prediction model.The delirium risk prediction model was established with Y=-7.326+0.066×age+2.056×blood transfusion+1.103×pulmonary infection,and the curve area under ROC was 0.813[95%CI(0.748,0.879)],the sensitivity of prediction was 0.886,and the specificity was 0.638.Youden’s index was-2.475.Conclusions:The risk of delirium after transurethral resection of prostate increased 1.069 times with each increase in age of one year.The risk of delirium in patients with blood transfusion was 7.812 times higher than that in patients without blood transfusion,and the risk of delirium in patients with lung infection was 3.013 times higher than that in patients without lung infection.This model has good predictive effect and can provide reference for medical sta

关 键 词：前列腺增生 经尿道前列腺电切术 术后谵妄 危险因素 风险预测模型 

分 类 号：R473.6[医药卫生—护理学]