PCI术后卧床便秘病人并发心脏不良事件列线图预测模型的构建  

Construction of Nomogram prediction model for cardiac adverse events in bedridden constipation patients after PCI surgery

作　　者：冷梅芳[1] 黄琨[1] 叶泽兵[1] 郭凯 曾文苑[1] 官梦霞 LENG Meifang;HUANG Kun;YE Zebing;GUO Kai;ZENG Wenyuan;GUAN Mengxia(Guangdong Second Provincial Ceneral Hospital,Guangdong 510317 China)

机构地区：[1]广东省第二人民医院,广东510317

出　　处：《护理研究》2024年第3期420-425,共6页Chinese Nursing Research

基　　金：2021年广东省第二人民医院护理提质创新研究项目,编号:YH2021-005。

摘　　要：目的:分析经皮冠状动脉介入(PCI)术后卧床便秘病人并发心脏不良事件的危险因素,并建立预测列线图模型。方法:选取2020年11月—2021年10月我院收治的248例PCI围术期卧床便秘病人作为研究对象,根据病人住院治疗期间是否发生心脏不良事件分为心脏不良事件组和非心脏不良事件组。收集两组临床资料并进行单因素和二元Logistic回归分析,得出独立预测因素,基于此构建列线图风险模型,并对该模型进行预测效能评价。结果:病人心脏不良事件发生率为17.3%。单因素和二元Logistic回归分析结果表明,病人年龄≥68岁[OR=9.970,95%CI(2.599,38.251)]、平卧位排便[OR=3.308,95%CI(1.074,10.188)]、D-二聚体≥402.99 ng/mL[OR=29.901,95%CI(8.800,101.601)]和左心室射血分数≤47.46%[OR=23.540,95%CI(7.118,77.853)]是PCI术后卧床便秘病人并发心脏不良事件的独立危险因素(P<0.05)。基于以上影响因素建立列线图风险模型,验证结果显示模型一致性指数(C-index)为0.955,校正曲线显示该列线图模型具有良好的区分度及一致性。结论:PCI术后卧床便秘病人年龄、排便体位、D-二聚体水平及左室射血分数与心脏不良事件发生存在密切关系,基于此建立的列线图模型有助于临床护理人员早期识别高危病人。Objective:To analyze the risk factors of adverse cardiac events in bedridden constipation patients after PCI and establish a predictive nomogram model.Methods:A total of 248 patients with constipation in bed during PCI perioperative period admitted to our hospital from November 2020 to October 2021 were selected as the research objects.According to whether the patients had cardiac adverse events during hospitalization,they were divided into cardiac adverse events group and non-cardiac adverse events Group.Collect two groups of clinical data for single factor and binary logistic regression analysis to obtain independent predictive factors,build a nomogram risk model based on this,and evaluate the predictive efficacy of the model.Results:The incidence of adverse cardiac events was 17.3%.Univariate and binary logistic regression analysis showed that patients were≥68 years old(OR=9.970,95%CI 2.599-38.251),defecation in supine position(OR=3.308,95%CI 1.074-10.188),D dimerization body≥402.99 ng/mL(OR=29.901,95%CI 8.800-101.601)and left ventricular ejection fraction≤47.46%(OR=23.540,95%CI 7.118-77.853)are patients with bedridden constipation after PCI with heart Independent risk factors for adverse events(P<0.05).A nomogram risk model was established based on the above influencing factors.The model verification results showed that the model consistency index(C-index)was 0.955,and the calibration curve showed that the nomogram model had good discrimination and consistency.Conclusions:The age,defecation position,D-dimer level,and left ventricular ejection fraction of patients with constipation in bed after PCI are closely related to the occurrence of adverse cardiac events.The nomogram model established based on this is helpful for clinical nurses to identify high-risk early patient.

关 键 词：卧床 便秘 心脏不良事件 列线图模型 危险因素 

分 类 号：R473[医药卫生—护理学]