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Received:September 28, 2021 Published Online:May 20, 2022
Received:September 28, 2021 Published Online:May 20, 2022
中文摘要: 目的 探讨儿童术中低体温发生的相关因素。构建并验证儿童术中低体温的预测模型,并转换成可视化列线图。方法 采用便利抽样方式,选取于2019年1月1日至8月30日在某三级甲等儿童专科医院接受手术治疗患儿的临床资料进行回顾性研究。使用R语言统计软件将前期数据按70%和30%比例随机抽取建模组和验证组。建模组数据进行多元Logistic 回归分析并建立术中低体温风险预测模型,根据Logistic回归方程构建列线图,并在验证组中验证。结果 共收集1 085例患儿临床资料。儿童术中低体温发生率为17.33%。手术类型、年龄、ASA分级和术前体温是儿童发生术中低体温的独立影响因素(P<0.05,P<0.01)。建模组列线图预测儿童术中体温过低的风险的ROC曲线下面积为0.670。验证组列线图的ROC曲线下面积为0.689。KS校准曲线拟合度检验结果显示模型可信度高,变异度小,拟合度尚可。结论 术中低体温是儿童手术常见的不良反应。构建的列线图对儿童术中低体温的预测能力尚可,可为儿童术中低体温的早期预防与控制提供一定的依据。
Abstract:ObjectiveTo understand the incidence of intraoperative hypothermia in children and explore its related factors. And to build and verify the prediction model of intraoperative hypothermia in children, and convert it into a visual nomogram. Methods Convenience sampling was used to select children who received surgical treatment in a children's hospital from January 1, 2019 to August 30, 2019. The R language statistical software was used to randomly select the modeling grouPand verification grouPaccording to the proportion of 70% and 30%. The data of the modeling grouPwere analyzed by multiple logistic regression, and the risk prediction model of intraoperative hypothermia was established. The nomogram was constructed according to the logistic regression equation and verified in the validation group. Results The clinical data of 1 085 children were collected. The incidence of hypothermia in children was 17.33%. Operation type, age, ASA grade and preoperative body temperature were independent influencing factors of intraoperative hypothermia in children (P<0.05, P<0.01). The area under the ROC curve for predicting the risk of intraoperative hypothermia in children was 0.670. The area under the ROC curve of the nomogram in verification grouPwas 0.689. The fitting test results of KS calibration curve showed that the model had high reliability, small variability and acceptable fitting degree. Conclusions Intraoperative hypothermia is a common adverse reaction in children. The nomogram can predict intraoperative hypothermia in children, and can provide a certain basis for the early prevention and control of intraoperative hypothermia in children.
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基金项目:上海交通大学医学院科技基金项目 (Jyhz2002);上海交通大学医学院护理高原学科建设百人计划(Hlgy1853qnhb)
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