乳腺癌患者手术麻醉苏醒后24 h支持性照护需求预测模型的构建

Establishment of predictive model for 24 h supportive care needs of breast cancer patients after recovery from anesthesia

目的探讨影响乳腺癌患者手术麻醉苏醒后24 h支持性照护需求独立影响因素并建立预测模型。方法选取2020年10月-2021年2月在我院乳腺科行乳腺癌手术治疗的363例患者为研究对象,将其支持性照护需求情况分为“无/低需求”组(n=72)和“中/高需求”组(n=291),比较2组影响因素并建立预测模型,采用ROC曲线验证预测模型的预测效能。结果经单因素及多因素分析发现,主要照顾者、新辅助化疗次数、家庭亲密度和适应性、安德森症状评估及麻醉恢复质量是乳腺癌患者手术麻醉苏醒后24 h中/高支持性照护需求的独立影响因素。预测模型为P=0.886,ROC曲线下面积为0.871,约登指数为0.699,灵敏度为0.753,特异性为0.847。模型验证正确率为93.65%,提示其预测效果较好。结论本预测模型效果良好,为医护人员对患者实施支持性照护服务提供理论参考。

Objective To explore the independent influencing factors of 24 h supportive care needs of breast cancer patients after recovery from anesthesia and establish a predictive model.Methods A total of 363 breast cancer patients underwent surgical treatment in breast cancer department of our hospital from October 2020 to February 2021 were selected as the study subjects,and all patients according to the need of supportive care was divided into"No/low need"group(n=72)and"Medium/high need"group(n=291).The influencing factors between the two groups were compared and a prediction model was established.ROC curve was used to verify the prediction efficiency of the model.Results By single factor and multi-factor analysis,it was found that primary caregiver,times of neoadjuvant chemotherapy,family cohesion and adaptability,Andson symptom Assessment,and quality of anesthesia recovery were independent factors influencing the need for 24 h moderate or high supportive care in patients with breast cancer after recovery from surgical anesthesia.The prediction model was P=0.886,the area under the ROC curve was 0.871,the Yoden index was 0.699,the sensitivity and specificity were 0.753 and 0.847.The accuracy of model verification was 93.65%,which indicated that the prediction effect was good.Conclusion The prediction model is effective and can be used as a theoretical reference for medical staff to implement supportive care service for patients.