临床小儿外科杂志2024，Vol.23Issue(7)：620-626,7.DOI:10.3760/cma.j.cn101785-202406025-004
婴幼儿法洛四联症完全矫治术后重症监护室滞留的危险因素及列线图模型构建
Risk factors and nomogram model construction for prolonged intensive care unit stay after complete correction of tetralogy of Fallot in infants and young children
摘要
Abstract
Objective To investigate the risk factors for prolonged intensive care unit(ICU)stay after complete correction of tetralogy of Fallot(TOF)in infants and young children and to construct a nomogram that predicts the risk of postoperative ICU stay.Methods A retrospective analysis was conducted on 157 children with TOF who underwent complete correction surgery at the Fuwai Central Cardiovascular Hospital Children's Heart Center from January 2021 to March 2024.The patients were divided into two groups based on whether they experienced prolonged ICU stay postoperatively:the prolonged stay group(n=40)and the non-prolonged stay group(n=117).Clinical data of the patients were collected,and the least absolute shrinkage and selection operator(LASSO)regression,univariate,and multivariate logistic regression analysis were performed to identify independent predictors of prolonged ICU stay.A nomogram was then constructed based on these predictors,and its predictive value was evaluated using the receiver operating characteristic(ROC)curve.Results Multivari-ate logistic regression analysis showed that preoperative low body weight(OR=0.607,95％CI:0.391～0.890,P=0.015),high neutrophil-lymphocyte ratio(NLR)(OR=2.499,95％CI:1.483～4.680,P＜0.001),lon-ger cardiopulmonary bypass time during surgery(OR=1.037,95％CI:1.006～1.078,P=0.034),longer du-ration of postoperative mechanical ventilation(OR=1.094,95％CI:1.057～1.149,P＜0.001),and occur-rence of complications(OR=14.632,95％CI:3.074～94.866,P=0.002)were independent predictors of prolonged ICU stay.In internal validation,the ROC curve showed that the nomogram had a good predictive per-formance for the risk of prolonged ICU stay after complete correction of TOF in infants and young children,with an area under the curve of 0.981(95％CI:0.965～0.998).Conclusions The nomogram based on body weight,preoperative NLR,cardiopulmonary bypass time,postoperative mechanical ventilation duration,and oc-currence of complications has a high predictive value for the risk of prolonged ICU stay after complete correction of TOF in infants and young children.关键词
列线图/法洛四联症完全矫治术/危险因素/外科手术/儿童Key words
Nomogram/Complete Correction of Tetralogy of Fallot/Risk Factors/Surgical Proce-dures,Operative/Child引用本文复制引用
闫崇阳,赵力运,宋书波,梁维杰,袁心刚,李萌浩,范太兵..婴幼儿法洛四联症完全矫治术后重症监护室滞留的危险因素及列线图模型构建[J].临床小儿外科杂志,2024,23(7):620-626,7.基金项目
河南省医学科技攻关计划项目(SBGJ202001005) Medical Science and Technology Project of Henan Province(SBGJ202001005) （SBGJ202001005）
