在非心脏胸部手术后的重症监护室患者中,术后肺部并发症的预测模型
Xiangjun He1, Meiling Dong1, Huaiyu Xiong1
1Department of Critical Care Medicine, West China Hospital, Sichuan University and Institute of Critical Care Medicine, No. 17, Section 3, Renmin South Road, Wuhou District, Chengdu City, Sichuan Province, 610041, China.
BMC pulmonary medicine
|August 29, 2024
概括
在非心脏胸部手术后的重症监护室 (ICU) 患者面临高风险的术后肺部并发症 (PPC). 开发的预测模型准确评估个人PPC风险,改善患者管理.
科学领域:
- 胸部外科手术 胸部外科手术
- 密集护理医学 密集护理医学
- 肺部医学 肺部医学
背景情况:
- 手术后肺部并发症 (PPC) 是手术患者死亡和不良结果的主要原因.
- 之前没有研究集中在非心脏胸部手术后的重症监护室 (ICU) 患者的PPC上.
- 在这个特定的患者群体中缺乏PPC的有效预测模型.
研究的目的:
- 调查非心脏胸部手术的ICU患者中PPC的发生率和风险因素.
- 在这个人群中开发和验证PPC的预测模型.
- 将开发模型的准确性与现有的风险模型进行比较.
主要方法:
- 在非心脏胸部手术后的475名ICU患者的回顾性队列研究 (2019年7月至2022年12月).
- 患者分为发展 (70%) 和验证 (30%) 队列.
- 单变量和多变量逻辑回归分析用于识别预测因素和建立预测模型.
主要成果:
- 至少有一种PPC的发病率为36.0%,肺炎是最常见的 (32.21%).
- PPC显著增加了机械通风持续时间,ICU停留时间,住院时间和再灌输率.
- 开发的预测名录显示了强大的歧视 (在ICU入院时AUC为0.766,在输出管后为0.841) 和表现优于报告的模型.
结论:
- 接受非心脏胸部手术的ICU患者患PPC的风险很高.
- 构建的预测名ograms为评估个人PPC风险提供了卓越的准确性,灵敏性和特异性.
- 这些模型可以帮助改善术后管理和患者的治疗结果.
相关概念视频
01:27Pneumothorax-II
127
Pneumothorax is a medical condition defined by the buildup of air in the pleural space between the lungs and the chest wall. This accumulation of air can lead to partial or complete lung collapse, resulting in a range of clinical manifestations. Understanding the clinical presentation and effective management strategies is crucial for healthcare professionals in providing timely and appropriate care to individuals with pneumothorax.
Clinical Manifestations:
Clinical Manifestations:
127
01:30Pneumonia III: Complications and Assessment
189
Pneumonia poses the potential for numerous complications that warrant consideration. These complications include the following:
189
01:26Endoscopic Studies II: Thoracocentesis
223
Thoracentesis(Thoracocentesis), commonly known as pleural tap, is a medical procedure where a 22 gauge needle is inserted into the pleural space, the area between the lung and chest wall. This procedure is commonly performed to diagnose or treat various respiratory disorders.
Description
Excess pleural fluid or air may accumulate in some respiratory disorders in the thoracic cavity. To treat pleural effusion, a physician conducts thoracentesis by carefully piercing the chest wall and entering...
Description
Excess pleural fluid or air may accumulate in some respiratory disorders in the thoracic cavity. To treat pleural effusion, a physician conducts thoracentesis by carefully piercing the chest wall and entering...
223
01:30Pneumonia I: Introduction
214
Pneumonia is an acute respiratory infection that targets the lungs, specifically the alveoli. These tiny air sacs, essential for oxygen exchange, become engorged with pus and fluid, severely hindering breathing, decreasing oxygen absorption, and causing significant pain and discomfort during respiration.
Risk Factors
Various factors influence the likelihood of developing pneumonia. Age plays a crucial role, with infants, children under two, and individuals over 65 at increased risk due to their...
Risk Factors
Various factors influence the likelihood of developing pneumonia. Age plays a crucial role, with infants, children under two, and individuals over 65 at increased risk due to their...
214
01:30Pneumonia V: Nursing management and Prevention
1.9K
Nursing management of pneumonia involves promoting airway patency, facilitating rest and conserving energy, encouraging fluid intake, maintaining nutrition, and educating patients.
The nurse must practice strict medical asepsis and adhere to infection control guidelines to minimize healthcare-associated infections.
Enhance airway patency
Position the patient correctly to facilitate drainage of the affected lung segments. Manual or mechanical percussion and vibration can also be employed....
The nurse must practice strict medical asepsis and adhere to infection control guidelines to minimize healthcare-associated infections.
Enhance airway patency
Position the patient correctly to facilitate drainage of the affected lung segments. Manual or mechanical percussion and vibration can also be employed....
1.9K
01:26Pneumothorax-I
177
A pneumothorax is a condition where air builds up in the space between the lung and the chest wall, causing the lung to collapse. This condition arises when air enters the space between the parietal and visceral pleura, disrupting the negative pressure essential for lung inflation. This can lead to a partial or complete collapse of the lung.
Pneumothorax can be even further classified as spontaneous, traumatic, and tension pneumothorax.
Pneumothorax can be even further classified as spontaneous, traumatic, and tension pneumothorax.
177