基于明尼苏达多项人格测验的冠状动脉搭桥术后发生谵妄的预测模型构建

Prediction model of postoperative delirium after coronary artery bypass grafting based on MMPI

目的利用术前获知的患者明尼苏达多项人格测验(minnesota multiple personality inventory,MMPI)结果,预测冠状动脉术术后谵妄发生的可能性,以备提前干预。方法选取2020年9月至2022年9月在郑州大学第一附属医院心血管外科进行冠状动脉搭桥术的患者193例,以是否出现术后谵妄分为两组,利用Bayes判别分析方法建立判别方程,并采用自身验证回代法对函数式进行检验。结果根据MMPI各维度建立判别函数:Y1(发生术后谵妄)=-29.589+0.190×抑郁-0.042×精神衰弱+0.554×精神分裂+0.186×轻躁狂;Y2(未发生术后谵妄)=-21.626+0.161×抑郁+0.069×精神衰弱+0.482×精神分裂+0.048×轻躁狂。用回代法验证该方程式的准确率达81.3%,模型的分类性能良好。结论建立的Bayes判别函数对冠状动脉搭桥术术后谵妄预测分类能力较强,能够为临床治疗方案制定和术前心理干预提供参考依据。

Objective To predict the possibility of delirium after coronary artery bypass grafting surgery based on the results of Minnesota Multiple Personality inventory(MMPI)performed before operation,so as to prepare for early intervention.Methods A total of 193 patients who underwent cardiac artery bypass grafting in the Department of Cardiac Surgery of the First Affiliated Hospital of Zhengzhou University from September 2020 to September 2022 were selected and divided into two groups according to whether postoperative delirium occurred.Bayes discriminant analysis method was used to establish the discriminant equation,and self-validation back-substitution method was used to test the functional formula 1 year.Results The discriminant function was established according to each dimension of MMPI,as follows:Y1(postoperative delirium)=-29.589+0.190×Depression-0.042×Psychosis+0.554×Schizophrenia+0.186×Hypomania.Y2(no postoperative delirium)=-21.626+0.161×Depression+0.069×Psychosis+0.482×Schizophrenia+0.048×Hypomania.The accuracy of the equation was 81.3% and the classification performance of the model was proved good.Conclusion The established Bayes discriminant function has a strong ability to predict the possibility of delirium after coronary artery bypass grafting,which can provide a reference for the clinical treatment plan making and preoperative psychological intervention nursing.