颈静脉穿刺针拔出后发生急性呼吸窘迫综合征预测模型的建立

Establishment of early warning model for acute respiratory distress syndrome after jugular puncture needle extraction

目的:探讨颈静脉穿刺针拔出后发生急性呼吸窘迫综合征(ARDS)的危险因素,并建立颈静脉穿刺针拔出后发生ARDS的列线图模型。方法:选取2017年3月—2020年4月在我院胃肠外科进行诊治的2400例颈静脉穿刺病人作为研究对象,采用Logistic回归分析筛选颈静脉穿刺针拔出后发生ARDS的危险因素,采用R(R3.5.3)软件建立预测颈静脉穿刺针拔出后发生ARDS的风险列线图模型。结果:2400例颈静脉穿刺针拔出后ARDS发生率为1.67%。Logistic回归分析结果显示,年龄≥60岁、糖尿病、休克、肺部感染、低氧血症及吸烟是颈静脉穿刺针拔出后发生ARDS的危险因素(P<0.05)。列线图模型结果显示,模型一致性指数(C-index)为0.817。校正曲线与理想曲线基本一致,受试者工作特征曲线(ROC)下面积(AUC)为0.791,决策曲线显示阈值概率在2%~96%时具有较高的净获益值。结论:基于危险因素建立的颈静脉穿刺针拔出后发生ARDS预测模型可以较好地预测颈静脉穿刺针拔出后ARDS的发生风险。

Objective:To explore the risk factors of acute respiratory distress syndrome(ARDS)after jugular puncture needle withdrawal,and to establish nomogram model of ARDS after jugular puncture needle withdrawal.Methods:A total of 2400 patients with jugular vein puncture who were diagnosed and treated in the department of gastrointestinal surgery of our hospital from March 2017 to April2020 were selected as the research subjects.Logistic regression analysis was used to screen the risk factors of ARDS after jugular puncture needle extraction.R(R3.5.3)software was used to establish Nomographic model for predicting the risk of ARDS after jugular puncture needle extraction.Results:The incidence of ARDS in 2400 patients with jugular vein puncture was 1.67%.Logistic regression analysis showed that age≥60 years old,diabetes,shock,pulmonary infection,hypoxemia and smoking were the risk factors for ARDS after jugular puncture needle extraction(P<0.05).The results of the nomogram model showed that the model consistency index(C-index)was0.817.The calibration curve was basically the same as the ideal curve,the area under the receiver operating characteristic(ROC)curve(AUC)was 0.791.And the decision curve showed that the net benefit value was higher when the threshold probability ranged from 2%to 96%.Conclusions:The early warning model for acute respiratory distress syndrome after jugular puncture needle extraction based on risk factors can help predict the risk of ARDS after jugular puncture needle withdrawal.