老年人慢性手术后疼痛的危险因素:单中心回顾性研究
Li-Heng Li1, Hao Guo2, Feng-Zhi Su3
1Department of Anesthesiology, The First Affiliated Hospital of Guangxi Medical University, Nanning, People's Republic of China.
Clinical interventions in aging
|December 10, 2025
概括
确定老年患者慢性术后疼痛 (CPSP) 的危险因素至关重要. 虚弱是一种普遍的风险因素,具体因素因手术类型而异,使得量身定制的预防策略成为可能.
科学领域:
- 老年人手术是一门老年手术.
- 疼痛医学 医学 疼痛医学
- 医疗保健中的机器学习
背景情况:
- 慢性手术后疼痛 (CPSP) 是老年患者的常见并发症.
- 根据外科手术期间的因素和患者精神状况预测CPSP需要进一步调查.
研究的目的:
- 在接受非心脏手术的老年患者中确定3个月CPSP的术后风险因素.
- 将CPSP定义为疼痛强度≥3在数值评分尺度上在3个月的随访后.
主要方法:
- 对367名老年患者进行了回顾性研究,涉及三个手术子组.
- 使用描述性统计和机器学习算法 (10 种模型) 分析变量.
- 模型性能通过5倍交叉验证进行评估;SHAP用于因子解释.
主要成果:
- 整体3个月CPSP患病率为25.07%,根据手术不同:骨科 (48.05%),尿道瘤 (10.34%),腹部瘤 (7.14%).
- 随机森林模型在子组中表现出强大的预测能力.
- 脆弱性被确定为普遍的风险因素;手术特异性因素也被注意到.
结论:
- 数据驱动的模型可以可靠地预测老年患者的CPSP.
- 脆弱性是所有手术类型的关键风险因素.
- 特定于手术的风险概况支持量身定制的术后评估和预防.
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