全麻术后发生低血压风险的列线图预测模型的构建

Construction of a nomogram prediction model for the risk of hypotension after general anesthesia

目的:分析全麻术后发生低血压的危险因素以及构建列线图模型并验证。方法:收集149例接受全麻手术的病人,根据术后是否发生低血压分为低血压组和非低血压组,使用单因素和多因素logistic回归分析术后发生低血压的危险因素,之后构建列线图模型并验证。结果:多因素logistic回归提示ASA分级、手术时间以及术前白细胞计数是术后发生低血压的独立预测因子。基于以上指标构建的列线图模型的AUC为0.757,Bootstrap重抽样验证的平均AUC为0.744(95%CI:0.717~0.769),校准曲线显示模型预测概率与实际发生率有较好的一致性。结论:ASA分级、手术时间以及术前白细胞计数能预测全麻术后病人发生低血压的风险,基于以上指标构建的列线图有较好的预测能力,对临床工作者预测全麻术后低血压的发生有一定的辅助作用。

Objective:To analyze the risk factors of hypotension after general anesthesia,and constructa nomogram model and verify it.Methods:One hundred and forty-nine patients with general anesthesia were collected,and divided into the hypotension group and non-hypotension group according to whether hypotension occurrence after surgery.The univariate and multivariate logistic regression were used to analyze the risk factors of hypotension after surgery,and then a nomogram model was constructed and verified.Results:The results of multivariate logistic regression analysis showed that the ASA grade,duration of surgery and preoperative white blood cell count were the independent predictors of postoperative hypotension.The area under the curve(AUC)of nomogram model based on these indicators was 0.757.The average AUC value of Bootstrap resampling verification was 0.744(95%CI:0.717-0.769).The calibration curve demonstrated a good agreement between the predicted probability of model and actual incidence.Conclusions:The ASA grade,duration of surgery and preoperative white blood cell count can be used to assess the risk of hypotension in patients after general anesthesia.The nomogram model constructed by these indicators has good predictive ability,and it is helpful for clinical workers to predict the occurrence of hypotension after general anesthesia.