ICU患者外周动脉导管非计划性拔管风险预测模型的构建及验证  

Construction of risk prediction model for unplanned peripheral arterial catheter extubation in ICU patients and its verification

作　　者：栾诚 郭凡 嵇艳[2] Luan Cheng;Guo Fan;Ji Yan(ICU,Suzhou Hospital,Nanjing Medical University,Nanjing 215002,China)

机构地区：[1]南京医科大学附属苏州医院ICU,江苏苏州215002 [2]南京医科大学护理学院

出　　处：《护理学杂志》2023年第6期63-67,共5页Journal of Nursing Science

基　　金：南京医科大学内涵建设专项护理学优势学科资助项目[苏政办发(2018)87号];苏州市立医院护理类科研项目(Slyyhl202102)。

摘　　要：目的构建并验证ICU患者外周动脉导管非计划性拔管的风险预测模型。方法选择300例(建模组)ICU留置外周动脉导管患者作为研究对象,回顾性收集患者相关资料,采用单因素分析、logistic回归分析筛选非计划性拔管的危险因素,构建风险预测模型。选择117例ICU留置外周动脉导管患者对风险预测模型进行验证。结果建模组23.00%患者发生非计划性拔管。年龄≥65岁,并存高血压、静脉血栓栓塞症,置入部位为桡动脉及置入导管为静脉留置针是ICU患者外周动脉导管非计划性拔管的高危因素(均P<0.05)。预测模型的ROC曲线下面积为0.888。模型验证结果显示,ROC曲线下面积为0.903,灵敏度为86.2%,特异度为85.2%,约登指数为0.714。结论构建的ICU患者外周动脉导管非计划性拔管的风险预测模型预测效果良好,可为医护人员及时采取预防性护理措施提供依据。Objective To construct and validate the risk prediction model of unplanned peripheral arterial catheter extubation in ICU patients.Methods Totally 300 ICU patients(the derivative group)with peripheral arterial catheter were selected and their clinical data were collected retrospectively.The risk factors of unplanned extubation were screened using univariate analysis and logistic regression analysis,and the risk prediction model was constructed.A total of 117 ICU patients with indwelling peripheral arterial catheters were selected to verify the model.Results Totally,23.00%patients in the derivative group had unplanned extubation.Age≥65 years old,hypertension,venous thromboembolism,radial artery as the insertion site,and use of venous catheter for catheterization were risk factors for unplanned extubation(all P<0.05).The area under the ROC curve of the prediction model was 0.888.The validation results of the model showed that the area under the ROC curve was 0.903,with the Yoden index,sensitivity and specificity of 0.714,86.2%and 85.2%respectively.Conclusion The risk prediction model constructed has good performance in identifying ICU patients at risk for unplanned peripheral arterial catheter extubation,which can provide evidence for medical staff to take preventive measures.

关 键 词：外周动脉导管 有创血压监测 非计划性拔管 静脉血栓栓塞症 高血压 静脉留置针 桡动脉 预测模型 

分 类 号：R472[医药卫生—护理学]