无痛胃肠镜检查中不良事件发生的模型构建

Model Construction of Adverse Events in Painless Gastroenteroscopy

目的探讨无痛胃肠镜检查中不良事件发生的模型构建。方法回顾性分析2020年1月至2021年12月于本院收治的接受无痛胃肠镜的患者422例的临床资料,根据患者是否发生不良事件分为发生组(n=151)与未发生组(n=271)。比较两组患者的一般资料。无痛胃肠镜检查中不良事件发生的危险因素主要依据Logistic回归分析进行分析,绘制受试者工作特征曲线(ROC)对曲线下面积(AUC)进行探讨。结果不良事件包括血压波动50例、心率波动72例、低氧血症18例、心律失常9例,2例胃穿孔、出血2例,共计151例。发生组与未发生组患者年龄、BMI、吸烟史及肺部疾病比较具有差异性(P<0.05);Logistic回归模型Logit P=3.792+0.852年龄+1.257BMI+0.928肺部疾病史,结果显示无痛胃肠镜不良事件发生的危险因素包括年龄、BMI、肺部疾病史(P<0.05)。联合检测模型,预测无痛胃肠镜过程中发生不良事件的AUC为0.881(95%CI 0.77-0.84),特异度与敏感度分别为79.03%与66.81%。结论无痛胃肠镜检查不良事件的危险因素包括年龄、BMI、肺部疾病史,危险因素对于预测不良事件的发生具有一定的价值,有助于在无痛胃肠镜检查提高安全性。

Objective To explore the model of adverse events in painless gastroenteroscopy.Methods Clinical data of 422 patients admitted to our hospital from January 2020 to December 2021 who received painless gastroenteroscopy were retrospectively analyzed,and they were divided into occurrence group(n=151)and non-occurrence group(n=271)according to whether adverse events occurred.The general data of the two groups were compared.The risk factors of adverse events in painless gastroenteroscopy were analyzed mainly by Logistic regression analysis,and the area under the curve(AUC)was investigated by receiver operating characteristic curve(ROC).Results The adverse events included blood pressure fluctuation in 50 cases,heart rate fluctuation in 72 cases,hypoxemia in 18 cases,arrhythmia in 9 cases,gastric perforation in 2 cases and hemorrhage in 2 cases,a total of 151 cases.There were differences in age,BMI,smoking history and lung disease between the two groups(P<0.05).Logistic regression model Logit P=3.792+0.852 age+1.257BMI+0.928 history of lung disease,the results showed that the risk factors for the occurrence of painless gastroenteroscopy adverse events included age,BMI and history of lung disease(P<0.05).The AUC for predicting adverse events during painless gastroenteroscopy was 0.881(95%CI 0.77-0.84),and the specificity and sensitivity were 79.03%and 66.81%,respectively.Conclusion The risk factors for adverse events in painless gastroenteroscopy include age,BMI,and history of lung disease.Risk factors are valuable in predicting the occurrence of adverse events,and contribute to improving the safety of painless gastroenteroscopy.