破裂腹主动脉瘤开放术后围术期死亡危险因素分析及列线图预测模型构建  

Analysis of risk factors for perioperative mortality after open repair of ruptured abdominal aortic aneurysm and construction of a nomogram prediction model

作　　者：唐兴奎 林玉坤[2] 何嘉琳 罗喜俊 朱显军 梁俊杰 梁伟雄 Xingkui Tang;Yukun Lin;He Jialin;Luo Xijun;Zhu Xianjun;Liang Junjie;Liang Weixiong(Panyu Cental Hospital of Guangzhou,Guangzhou 511400,China;Department of Eletron Microscopy,Zhongshan School of Medicine,Sun Yat-sen University,Guangzhou 510080,China)

机构地区：[1]广州市番禺区中心医院,广州511400 [2]中山大学中山医学院电子显微镜室,广州510080

出　　处：《中华血管外科杂志》2021年第4期256-260,共5页Chinese Journal of Vascular Surgery

基　　金：广州市科技计划项目(201904010070)。

摘　　要：目的探讨破裂腹主动脉瘤(rAAA)开放术后围术期死亡危险因素并建立列线图预测模型。方法回顾性分析2010年1月至2020年12月广州市番禺区中心医院行开放手术的74例rAAA患者的临床资料,收集每位患者的基线资料和临床资料,使用Logistic回归分析围术期死亡的独立危险因素,并绘制列线图模型。结果74例rAAA患者中,围术期死亡率为20.3%(15/74),logistics回归分析结果显示年龄、糖尿病、冠心病、出血量是rAAA围术期死亡的独立危险因素(P<0.05)。基于筛选的独立危险因素,建立预测列线图模型。该模型曲线下面积为0.872(95%CI:0.794~0.934)。结论年龄、糖尿病、冠心病、出血量是rAAA围术期死亡的独立危险因素,以此建立的列线图风险模型具有较好的风险评估效能与准确度。Objective To explore the risk factors for perioperative mortality after open repair of ruptured abdominal aortic aneurysm(rAAA)and establish a nomogram prediction model.Methods To retrospectively analyze the clinical data of 74 patients with rAAA who had undergone open surgery at Guangzhou Panyu Central Hospital from January 2010 to December 2020.The baseline and clinical data of each patient were collected.Logistic regression was used to analyze independent risk factors for perioperative mortality,and a nomogram model was drawn.Results Among the included patients with rAAA,the perioperative mortality rate was 20.3%(15/74).The logistic regression analysis showed that age,diabetes,coronary heart disease,and volume of blood loss were the independent risk factors for perioperative mortality of rAAA(P<0.05).Based on the selected independent risk factors,a nomogram prediction model was established.The area under the curve(AUC)value of this model was 0.872(95%CI:0.794~0.934).Conclusion Age,diabetes,coronary heart disease,and volume of blood loss are independent risk factors for perioperative mortality of rAAA.The nomogram prediction model established by these independent risk factors shows good efficiency and accuracy in risk assessment.

关 键 词：破裂腹主动脉瘤 开放手术 危险因素 列线图 

分 类 号：R654.3[医药卫生—外科学]