全科护理2023，Vol.21Issue(34)：4759-4762,4.DOI:10.12104/j.issn.1674-4748.2023.34.002
机械通气病人脱机试验结局影响因素及预测模型构建
Influencing factors and prediction model construction of spontaneous breathing trial outcome of mechanical ventilation patients
摘要
Abstract
Objective:To investigate the factors influencing of spontaneous breathing trial(SBT)outcome of mechanical ventilation patients in intensive care unit(ICU),and construct a prediction model to provide reference for the selection of spontaneous breathing trial(SBT)for clinical patients.Methods:This study was a retrospective study.General data of 330 patients in the Department of Intensive Care Medicine of the Second People's Hospital of Lianyungang City from January 1 to December 31,2022 were collected,and they were divided into successful group(n=264)and failure group(n=66)according to the outcome of spontaneous breathing trial.General data of the two groups were compared and analyzed.Variables with statistically significant differences were selected for binary Logistic regression analysis,and a prediction model for the spontaneous breathing trial outcome was established according to the analysis results.Receiver operating characteristic(ROC)curve was drawn to verify the application efficiency of the model,and Hosmer-Lemeshow goodness of fit test was used to evaluate the prediction effect of the model.Results:Unifactor analysis showed that there were statistically significant differences in APACHE Ⅱ score,the number of days of tube insertion,sputum intensity,blood gas pH value before spontaneous breathing trial,albumin,state of consciousness,vasoactive drugs and Nutrition Score(NRS-2002)between the two groups(P＜0.05).Binary Logistic regression analysis showed that the number of days of tube insertion,sputum intensity,Nutritional Score,state of consciousness and vasoactive drugs were the influencing factors of spontaneous breathing trial outcome.According the receiver operating characteristic(ROC)curve was drawn.The area under the curve was 0.926[95％CI(0.896,0.956)],the Jorden index was 0.697,the cutoff value was 0.866,and the sensitivity was 0.879[95％CI(0.779,0.937)].The specificity was 0.818[95％CI(0.767,0.860)],and Hosmer-Lemeshow test showed no statistical significance(x2=6.253,P=0.619).Conclusions:The number of days of tube insertion,sputum intensity,state of consciousness,Nutritional Score and vasoactive drugs were the factors influencing the outcome of the spontaneous breathing trial,which could predict the outcome of spontaneous breathing trial.关键词
气管插管/机械通气/脱机试验/危险因素/预测模型Key words
endotracheal intubation/mechanical ventilation/spontaneous breathing trial/risk factors/prediction model引用本文复制引用
徐会美,郑燕琦..机械通气病人脱机试验结局影响因素及预测模型构建[J].全科护理,2023,21(34):4759-4762,4.基金项目
南京医科大学康达学院科研发展基金课题,编号:KD2021KYJJD095. （）
