在接受脊柱手术的患者中开发和验证术后肺炎预测模型:一项回顾性研究
Dong Xie1,2, Qing Chen1, Yao Zhang2
1Spine Center, Department of Orthopaedics, Shanghai Changzheng Hospital, Second Affiliated Hospital of Naval Medical University, Shanghai, 200003, China.
Heliyon
|May 6, 2024
概括
这项研究开发了脊柱手术后手术后肺炎 (POP) 的风险预测模型. 关键的风险因素包括手术时间,吸烟和慢性阻塞性肺病 (COPD).
科学领域:
- 脊柱外科手术 脊柱外科手术
- 肺部医学 肺部医学
- 医疗信息学 医疗信息学
背景情况:
- 手术后肺炎 (POP) 是脊椎手术后的一个严重并发症.
- 确定手术前的风险因素对于有效的预防策略至关重要.
研究的目的:
- 开发和验证一个预测模型,用于识别脊椎手术后高风险的POP患者.
- 确定与增加的POP风险相关的关键手术前因素.
主要方法:
- 使用多变量逻辑回归分析来确定POP的独立风险变量.
- 开发并使用ROC曲线,校准曲线和决策曲线分析 (DCA) 验证了一个名ogram预测模型.
- 分析了2223名训练组和357名验证组患者的数据.
主要成果:
- 手术时间,美国麻醉学会 (ASA) 级别,吸烟,不戴口罩,缺乏手术前呼吸训练,慢性阻塞性肺病 (COPD),潜在疾病和脊髓切割被确定为POP的风险因素.
- 该模型表现出高预测性能,ROC曲线下的面积在训练集中为0.950,在验证集中为0.879.
- 校准曲线显示出良好的一致性,DCA显示出高净收益.
结论:
- 开发的POP风险预测模型对于接受脊髓手术的患者来说是准确和有效的.
- 术前因素显著影响POP的发展,突出了针对性干预的需要.
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