基于多重对应分析与Logistic回归探究IABP支持下心血管危重患者院内转运不良事件的危险因素

Exploring the risk factors of in-hospital adverse transport events in cardiovascular critically ill patients supported by IABP based on multiple correspondence analysis and Logistic regression

目的分析主动脉内球囊反搏(IABP)支持下心血管危重患者院内转运不良事件现状及危险因素。方法选取2022年11月至2023年6月郑州市某两所三甲医院进行院内转运的IABP支持的心血管危重患者为研究对象,根据是否发生院内转运不良事件进行分组,通过单因素分析、二元Logistic回归分析筛选危险因素;采用多重对应分析探索不同类型不良事件与危险因素的关联程度。结果182例患者转运中有68例(37.36%)发生了不良事件,病情变化类不良事件发生率最高(43/23.63%),不良事件主要为血压波动(26/14.29%)、IABP氦气管路断开(16/8.79%)和血氧饱和度(SpO2)变化(10/5.49%)。使用儿茶酚胺类药物、转运目的地是IABP支持下心血管危重患者院内转运不良事件发生的危险因素(P<0.05)。多重对应分析显示病情变化不良事件与机械通气、镇痛镇静药物相关联。结论IABP支持下心血管危重患者院内转运不良事件发生率较高,临床医护人员应重视相关危险因素的识别,并采取综合措施提高患者院内转运的安全性。

Objective To analyze the current situation and risk factors of adverse events of in-hospital transport in cardiovascular critically ill patients supported by intra-aortic balloon pump(IABP).Methods From November 2022 to June 2023,cardiovascular critically ill patients supported by IABP who underwent in-hospital transport in two tertiary hospitals in Zhengzhou were selected as the research objects.The patients were grouped according to whether adverse events occurred during in-hospital transport.Risk factors were screened by univariate analysis and binary Logistic regression analysis.Multiple correspondence analysis was used to explore the correlation between different types of adverse events and risk factors.Results Among the 182 patients,68 cases(37.36%)had adverse events during transport,and the highest incidence of adverse events was disease change(43/23.63%).The main adverse events were blood pressure fluctuations(26/14.29%),IABP helium pipeline disconnection(16/8.79%)and blood oxygen saturation(SpO2)changes(10/5.49%).The use of catecholamines and the destination of transport were risk factors for adverse events of in-hospital transport in cardiovascular critically ill patients supported by IABP(P<0.05).Multiple correspondence analysis showed that adverse events were associated with mechanical ventilation,analgesic and sedative drugs.Conclusion The incidence of adverse events in in-hospital transport of cardiovascular critically ill patients supported by IABP is high.Clinical medical staff should pay attentions to the identification of related risk factors and take comprehensive measures to improve the safety of in-hospital transport of patients.