神经外科ICU患者误吸的列线图风险预测模型构建及其诊断效能  

Construction of nomogram prediction model for aspiration in neurosurgical ICU patients and its diagnostic efficacy

作　　者：谈月蓉 丁海燕 李育平 史甜 TAN Yue-rong;DING Hai-yan;LI Yu-ping;SHI Tian(Neurological Intensive Care Unit,Subei People's Hospital,Yangzhou 225000,Jiangsu,China)

机构地区：[1]苏北人民医院神经重症监护室,江苏扬州225000

出　　处：《川北医学院学报》2023年第11期1551-1554,共4页Journal of North Sichuan Medical College

基　　金：苏北人民医院护理研究专项(SBKY21050)。

摘　　要：目的:探讨神经外科ICU患者发生误吸的列线图风险预测模型及其诊断效能。方法:选取998例神经外科ICU患者为研究对象,根据患者入住ICU期间是否发生误吸分为误吸组(n=297)和非误吸组(n=701)。收集患者临床资料,单因素及多因素Logistic回归分析神经外科ICU患者发生误吸的危险因素,并根据分析结果,利用R软件构建神经外科ICU患者发生误吸的列线图风险预测模型;受试者工作特征(ROC)曲线验证模型的预测效能。结果:单因素分析结果显示,两组患者误吸史、意识障碍、床头抬高角度、胃残留量、胃肠减压、人工气道、机械通气、抑酸剂、肌松剂、镇静镇痛药及NIHSS评分差异有统计学意义(P<0.05)。多因素Logistic回归分析结果显示,意识障碍、胃残留量、机械通气、肌松剂、镇静镇痛药及NIHSS评分均是神经外科ICU患者发生误吸的独立风险因素(P<0.05)。神经外科ICU患者发生误吸列线图风险预测模型的ROC曲线下面积为0.978(95%CI:0.967~0.986),敏感度和特异度分别为96.58%、90.24%。结论:意识障碍、胃残留量、机械通气、肌松剂、镇静镇痛药及NIHSS评分均是神经外科ICU患者发生误吸的独立风险因素,基于以上风险因素构建的列线图风险预测模型具有较好的诊断效能。Objective:To explore the the nomogram risk prediction model and diagnostic efficacy for aspiration in neurosurgical ICU patients.Methods:A total of 998 patients were included and divided into aspiration group(n=297)and non-aspiration group(n=701)according to whether aspiration occurred during ICU stay.The clinical data of patients were collected,and the risk factors of aspiration in neurosurgical ICU patients were screened by univariate and multivariate Logistic regression analysis.According to the results of Logistic regression analysis,R software was used to construct a nomogram risk prediction model for aspiration in neurosurgical ICU patients,and the receiver operating characteristic(ROC)curve was used to verify the prediction efficiency of the model.Results:The results of univariate analysis showed that there were significant differences in aspiration history,disturbance of consciousness,bedside elevation angle,gastric residual volume,gastrointestinal decompression,artificial airway,mechanical ventilation,acid inhibitors,muscle relaxants,sedative analgesics and NIHSS scores between the two groups(P<0.05).Multivariate Logistic regression analysis showed that disturbance of consciousness,gastric residual volume,mechanical ventilation,muscle relaxants,sedative analgesics and NIHSS score were independent risk factors for aspiration in neurosurgical ICU patients(P<0.05).The AUC under the ROC curve of the risk prediction model of aspiration in neurosurgical ICU patients was 0.978(95%CI:0.967~0.986),and the sensitivity and specificity were 96.58%and 90.24%,respectively.Conclusion:Consciousness disorder,gastric residual volume,mechanical ventilation,muscle relaxant,sedative and analgesic drugs and NIHSS score are independent risk factors for aspiration in neurosurgical ICU patients.The nomogram risk prediction model based on the above risk factors has good diagnostic efficacy.

关 键 词：神经外科ICU 误吸 危险因素 列线图 预测 

分 类 号：R473.74[医药卫生—护理学]