神经外科重症患者精神错乱预测模型的应用研究

Study on the Application of Predictive Model of Mental Disorder in Critical Nursing Patients of Neurosurgery Department

目的构建并验证神经外科重症患者精神错乱预测模型的应用价值。方法选取2017年12月至2020年10月我院神经外科245例重症患者的临床资料,其中发生精神错乱者99例,未发生者146例,采用多因素Logistic回归性分析对12项精神错乱危险因素进行分析和建模,利用ROC曲线下面积进行预测效果检验,选取2020年11月至2022年5月我院神经外科重症护理患者105例进行模型应用效果检验。结果本研究最终预测模型认为性别、年龄、身体束缚情况、镇静药使用、利尿药使用、GCS评分是神经外科重症护理患者精神错乱发生的独立影响因子(P<0.05),神经外科重症护理患者精神错乱预测模型为:Y=1/[1-exp(X)],X=-5.388+0.873×性别+0.051×年龄+1.274×身体束缚+2.281×镇静药使用+1.871×利尿药使用-0.512×GCS评分。模型验证结果显示灵敏度80.00%、特异度89.41%、准确率87.62%。结论本研究模型对神经外科重症护理患者精神错乱的发生预测效果良好,对高危患者采取预见性护理干预措施,具有一定的临床指导意义。

Objective To construct and verify the application value of a mental disorder prediction model for intensive care patients in neurosurgery department.Methods The clinical data of 245 patients in the intensive care of brain surgery in our hospital from December 2017 to October 2020 were selected.Among them,99 cases were mentally disordered and 146 cases did not occur.Multivariate Logistic regression was used to analyze 12 risk factors of mental disorders and build the model.The area under the ROC curve was used to test the prediction effect,and 105 patients in intensive care of the brain surgery in our hospital from November 2020 to May 2022 were selected to test the effect application of the model.Results The final prediction model of this study concluded that gender,age,physicalrestraint,sedativeuse,diureticuse and GCS score were independent factors influencing the occurrence of mental disorders in intensive care patients of brain surgery(P<0.05),and the prediction model for confusion mentality of intensive care patients in brain surgery was:Y=1/[1-exp(X)],X=-5.388+0.873×gender+0.051×age+1.274×body restraint+2.281×sedative use+1.871×diuretic use-0.512×GCS score.The model verification results showed that the sensitivity was 80.00%,the specificity was 89.41%,and the accuracy was 87.62%.Conclusion This research model has a good predictive effect on the occurrence of mental disorders in intensive care patients of brain surgery,and has certain clinical guiding significance to take predictive intervention measures for high-risk patients.