在急性甲型大动脉解剖患者中,术后压力损伤的预测模型
Qiuji Wang1, Weiqi Feng, Wenhui Li
1Qiuji Wang, MS, is PhD Candidate, Department of Cardiac Surgery, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, China. Weiqi Feng, BS, is Master Candidate, School of Medicine, South China University of Technology, Guangzhou, China. Also at Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Wenhui Li, BS, and Shan Li, BS, are Nurse Practitioners, Department of Cardiac Surgery; Qiuyi Wu, BS, is Nurse, Department of Cardiac Surgery; Zhichang Liu, BS, is Nurse, Department of Cardiac Surgery Intensive Care Unit 1; Xin Li, MS, and Changjiang Yu, MS, are Deputy Chief Physicians, Department of Cardiac Surgery; Yunqing Cheng, BS, is Head Nurse, Department of Cardiac Surgery; and Ruixin Fan, PhD, is Chief, Department of Cardiac Surgery. Acknowledgments: Editorial support and funding for the publication charge for this research were supplied by the Science and Technology Planning Project of Guangdong Province (no. 2015A020214017). The authors have disclosed no other financial relationships related to this article. Submitted October 18, 2022; accepted in revised form March 16, 2023.
一种新的风险评估模型可以预测急性A型大动脉剖析手术后的压力损伤 (PI). 该模型识别高风险患者,有助于预防性护理策略的外科治疗结果.
科学领域:
- 心血管外科心血管外科
- 手术并发症 手术并发症
- 患者安全 患者安全
背景情况:
- 手术后的压力损伤 (PI) 是急性A型大动脉解剖 (aTAAD) 手术中的一个问题.
- 预测PI风险对于实施及时干预至关重要.
研究的目的:
- 开发和验证国家压力伤害咨询小组第二阶段或更高PI风险的预测模型.
- 在接受aTAAD手术的患者中确定PI的关键风险因素.
主要方法:
- 对469名接受aTAAD手术的患者进行了回顾性分析 (2017年9月 - 2021年6月).
- 用变量选择进行 LASSO 回归,然后进行多变量后勤分析.
- 模型验证使用校准图,ROC曲线和决策曲线分析.
主要成果:
- 94名患者 (27.5%) 发生了术后PI.
- 确定了关键预测因素:马凡综合征,手术前皮肤水分,白蛋白和血清肌.
- 预测模型实现了ROC曲线下的面积为0.765.
结论:
- 在aTAAD手术患者中建立了术后PI的高效预测模型.
- 该模型证明适用于识别患有高风险发展压力损伤的患者.


