中国实用儿科杂志2024，Vol.39Issue(2)：119-124,6.DOI:10.19538/j.ek2024020609
先天性心脏病术后脓毒症患儿列线图预后模型的构建与验证
Construction and validation of a predictive model for patients with sepsis after congenital heart disease surgery
摘要
Abstract
Objective To investigate the predictive factors of death in patients with sepsis after congenital heart disease surgery,and establish a nomogram prediction model.Methods The clinical data of children who developed sepsis after cardiopulmonary bypass thoracotomy at Guangdong Provincial People's Hospital between January 2012 and December 2021 were collected.Univariate and multivariate logistic regression analysis was conducted to identify the risk factors associated with mortality in children with sepsis after congenital heart disease.Based on the results of the analysis,a nomogram prediction model was developed and the Bootstrap resampling method was used for internal verification.Results A total of 157 children were included in the study,with 135 survivors and 22 deaths.Univariate analysis and multivariate logistic regression analysis revealed several independent risk factors for death in children with sepsis after congenital heart disease surgery.These factors included the total time of postoperative fever(OR=1.084,95％CI 1.022-1.151),asoactive-inotropic score on the third day after surgery(OR=1.162,95％CI 1.070-1.263),and secondary thoracotomy(OR=6.033,95％CI 1.906-19.098).Based on the above-mentioned three indepe-ndent risk factors,a nomogram prediction model was developed with an area under curve of 0.909(95％CI:0.852-0.966).The identification C index of the Bootstrap resampling method was 0.9139(95％CI 0.9100-0.9178).The Hosmer-Lemeshow goodness of fit test demonstrated that the nomogram model accurately predicted the risk of death in children with sepsis after surgery(x2=7.617,P=0.472).Conclusion The duration of postoperative fever,vasoactive-inotropic score on the third day after surgery,and secondary thoracotomy are independent risk factors for death of children with sepsis after congenital heart disease surgery.Based on the risk factors,the nomogram prediction model is successfully constructed and verified to predict the survival outcome of sepsis patients with congenital heart disease after surgery.关键词
先天性心脏病/手术/脓毒症/死亡因素/列线图Key words
congenital heart disease/operation/sepsis/death factors/nomogram分类
医药卫生引用本文复制引用
罗玉婷,陈寄梅,陈纯玲,郭予雄,王春,王静,吴家兴,胡燕,郑贵浪,温树生..先天性心脏病术后脓毒症患儿列线图预后模型的构建与验证[J].中国实用儿科杂志,2024,39(2):119-124,6.基金项目
国家重点研发计划项目(2020YFC1107904,2022YFC2407406) （2020YFC1107904,2022YFC2407406）
