| 耿 苗,郑明阁.老年脊柱骨折患者术中低体温风险预测模型的建立与验证[J].中国烧伤创疡杂志,2025,(1):53~57. |
| DOI： |
| 中文关键词: 老年 脊柱骨折 术中低体温 预测模型 有效性 |
| 英文关键词:Elderly Spinal fractures Intraoperative hypothermia Prediction model Effectiveness |
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| 中文摘要: |
| 【摘要】 目的 建立老年脊柱骨折患者术中低体温风险预测模型, 并验证其有效性。方法 选取 2019 年 3月至 2023 年 3 月南阳医学高等专科学校第三附属医院收治的 300 例脊柱骨折患者作为研究对象, 以 2 ∶ 1 的比例按照随机数表法将其分为建模组 (200 例) 和验证组 (100 例), 根据建模组患者相关资料获得老年脊柱骨折患者术中低体温发生的独立危险因素, 建立预测模型, 并采用验证组相关资料验证模型有效性。结果 多因素Logistic回归分析结果显示, 年龄、基础体温、体重指数、美国麻醉医师协会 (ASA) 分级、术中输液量、麻醉时间、手术时间是老年脊柱骨折患者是否发生术中低体温的独立影响因素 (95%CI 为 1.315~ 2.303、1.154~ 8.589?1.187~ 8.009、1.433 ~ 13.439、1.254 ~ 9.777、1.057 ~ 4.421、1.151 ~ 3.517, P = 0.001、0.025、0.021、0.010?0.016、0.034、0.014), 得出预测模型公式为 P= 1 / {1+exp 〔- [-2.768+0.554 (年龄) +1.147 (基础体温) +1.126 (体重指数) + 1.479 ( ASA 分 级) + 1.253 ( 术 中 输 液 量) + 0.771 ( 麻 醉 时 间) + 0.699 ( 手 术 时间) ] 〕 }, 对模型相关系数进行整数转化后得出预测模型为 P = 1 / 〔 1 + exp [ - ( - 2.768 +危险因素总分×0.554) ] 〕。受试者操作特征 (ROC) 曲线分析结果显示, 曲线下面积为 0.834, 敏感度为 81.4%, 特异度为78.9%。Hosmer-Lemeshow 卡方检验结果显示, χ2 = 7.034, P = 0.676。结论 根据年龄、基础体温等老年脊柱骨折患者发生术中低体温的独立危险因素建立的风险预测模型具有较高的预测价值。 |
| 英文摘要: |
| 【Abstract】 Objective To establish and validate the risk prediction model for intraoperative hypothermia in elderly patients with spinal fractures. Methods 300 patients with spinal fractures admitted into The Third Affiliated Hospital of Nanyang Medical College from March 2019 to March 2023 were selected as the research subjects, and then divided into the modeling group (n = 200) and the validation group (n = 100) in a 2 ∶ 1 ratio using the random number table. Independent risk factors for intraoperative hypothermia in elderly patients with spinal fractures were identified using data from the modeling group, based on which a prediction model was established. The data from the validation group was used to validate the established model. Results The results of multifactorial Logistic regression analysis showed that age, basal body temperature, body mass index, American Society of Anesthesiologists (ASA) classification, intraoperative fluid infusion, anesthesia time, and operation duration were the independent risk factors for intraoperative hypothermia in elderly patients with spinal fractures (95%CI: 1.315-2.303, 1.154-8.589, 1.187-8.009, 1.433-13.439, 1.254-9.777, 1.057-4.421, 1.151-3.517, P= 0.001, 0.025, 0.021, 0.010, 0.016, 0.034 and 0.014), and the resultant formula of the prediction model was P= 1 / {1+exp 〔- [-2.768+0.554 (age) +1.147 (basal body temperature) + 1.126 (body mass index) +1.479 (ASA classification) + 1.253 ( intraoperative fluid infusion) + 0.771 ( anesthesia time) + 0.699 ( operation duration) ] 〕}. After integer transformation of model correlation coefficients, the formula of the prediction model was P =1 / 〔1+exp [- (-2.768+ risk factor total score×0.554) ] 〕. The receiver operating characteristic (ROC) curve showedthat the area under the curve was 0.834, with the sensitivity being 81.4% and the specificity being 78.9%. The Hosmer-Lemeshow chi-square test result showed χ2 = 7.034, P = 0.676. Conclusion The risk prediction model established based on independent risk factors such as age and basal body temperature has a high predictive value for intraoperative hypothermia in elderly patients with spinal fractures. |
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