开发,验证和可视化风险预测模型手术后发的患者接受视频辅助胸腔镜叶切除术:一个现实世界的回顾性研究
Fuhai Xia1, Qiang Li1, Zhineng Cheng1
1Department of Operating Room, Tongji Medical College, The Central Hospital of Wuhan, Huazhong University of Science and Technology, Wuhan, 430014, Hubei, China.
Scientific reports
|October 14, 2025
概括
这项研究开发了一种风险预测模型,用于视频辅助胸腔镜叶切除术后术后发. 该模型识别了高风险的患者,使得有针对性的干预措施能够预防并发症.
科学领域:
- 麻醉学和外科手术期间的医学.
- 胸部外科手术 胸部外科手术
- 医疗信息学 医疗信息学
背景情况:
- 手术后发是视频辅助胸腔镜 (VATS) 叶切除术后的常见并发症,可能导致不良后果.
- 现有的术后发风险分层工具有限,特别是在接受VATS叶切除术的患者中.
研究的目的:
- 开发,验证和可视化一个风险预测模型,用于手术后发的患者接受VATS叶切除术.
- 在这个患者群体中确定与术后发相关的独立风险因素.
- 创建一个用户友好的工具,用于临床实施和动态风险评估.
主要方法:
- 对530名接受VATS叶切除术的患者进行了回顾性分析.
- 数据随机划分为培训 (70%) 和验证 (30%) 集.
- 后勤回归分析以确定风险因素和开发名录仪.
- 使用AUC,校准曲线,Hosmer-Lemeshow测试和决策曲线分析 (DCA) 的模型性能评估.
- 创建一个在线可视化工具,用于风险评估.
主要成果:
- 术后发发生在37.36%的患者身上 (198/530).
- 确定了重要的风险因素:年龄<60岁,手术期间低温,麻醉后恢复延迟,没有术后止痛,手术持续时间>180分钟,以及较低的手术前体温.
- 命名仪显示出强烈的区别 (AUC:0.847培训,0.836验证) 和良好的校准.
- 在广泛的值概率 (0.20-0.98) 中,DCA表明了临床效用.
结论:
- 这项研究介绍了第一个风险预测模型和手术后发在VATS叶切除术患者的nomograph.
- 该模型整合了六个关键的术后变量,提供了一个可靠和临床适用的工具.
- 在线可视化工具促进了动态风险评估,使得有针对性的干预措施,以减轻动相关的并发症.
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