在食道癌患者的术后呼吸衰竭预测模型的构建和验证
Bo Yang1, Yue Bai1, Lili Lang1
1Department of Thoracic Surgery, Sun Yat-sen University Cancer Center Gansu Hospital, Lanzhou, China.
Journal of thoracic disease
|August 14, 2025
概括
这项研究确定了食道癌患者术后呼吸衰竭的关键风险因素. 使用这些因素的预测模型显示了早期干预的良好表现.
科学领域:
- 在瘤学瘤学.
- 呼吸系统医学 呼吸系统医学
- 手术并发症 手术并发症
背景情况:
- 手术后呼吸衰竭 (PRF) 是食道癌 (EC) 手术后的一种严重并发症,与高死亡率有关.
- 早期发现和干预对于改善患者的治疗结果至关重要.
- 这项研究的重点是确定风险因素,并开发EC患者中PRF的预测工具.
研究的目的:
- 在EC患者中探索与PRF相关的风险因素.
- 开发和验证PRF的预测模型.
- 加强早期诊断和个性化干预策略.
主要方法:
- 来自两个癌症中心的265名EC患者的临床数据的回顾性分析.
- 患者被分为培训,内部验证和外部验证组.
- 最小绝对收缩和选择操作员 (LASSO) -逻辑回归用于特征选择和模型构建.
主要成果:
- 确定的PRF风险因素包括吸烟指数≥400,一秒钟内低强制呼气量 (FEV1),手术前的低白血症,手术时间延长,以及静脉.
- 预测模型实现了良好的区分能力,AUC值为0.856 (训练),0.839 (内部验证) 和0.773 (外部验证).
- 该模型展示了有利的预测准确性和显著的临床实用性.
结论:
- 一个LASSO-逻辑回归模型有效地预测了EC患者的PRF.
- 该模型在内部和外部验证队列中显示出强大的性能和临床适用性.
- 这种工具可以帮助临床医生识别高风险患者,以便及时进行个性化干预.
相关概念视频
01:29Acute Respiratory Failure-V
208
The treatment for acute respiratory failure varies based on factors like the underlying cause, overall health, and severity. A collaborative healthcare team is essential for early detection, often through arterial blood gas analysis. Identifying the cause is the primary goal, with treatment strategies adjusted for ventilation/perfusion (V/Q) mismatch, shunting, or diffusion impairment.
Ensure that patients are monitored continuously for their response to therapy, including changes in...
Ensure that patients are monitored continuously for their response to therapy, including changes in...
208
01:30Assessment of Airway, Skin Color, and Use of Accessory Muscles
1.1K
A thorough assessment of respiratory health is paramount in clinical settings to identify and manage respiratory distress and ensure adequate oxygenation. This article elaborates on the critical aspects of respiratory evaluation, including airway assessment, skin color examination, and the observation of accessory muscle use, which are integral to effectively diagnosing and managing patients with respiratory conditions.
Introduction
The initial evaluation of a patient's respiratory system...
Introduction
The initial evaluation of a patient's respiratory system...
1.1K
01:19Respiratory Assessment: Purpose and Indications
1.2K
Respiratory assessment is a cornerstone of nursing assessments, crucial for the early detection of patient deterioration. This evaluation transcends routine procedures, representing a critical skill nurses must master to ensure optimal patient care.
Objectives and Importance:
The primary goal of respiratory assessment is to evaluate patients at early risk of clinical deterioration. Since respiratory distress often precedes other signs of declining health, breathing patterns and sounds become a...
Objectives and Importance:
The primary goal of respiratory assessment is to evaluate patients at early risk of clinical deterioration. Since respiratory distress often precedes other signs of declining health, breathing patterns and sounds become a...
1.2K