广西医学2024，Vol.46Issue(11)：1662-1669,8.DOI:10.11675/j.issn.0253-4304.2024.11.05
成人ICU住院患者发生显性误吸的危险因素及列线图预测模型的构建
Risk factors for the occurrence of dominant aspiration in ICU adult inpatients and the establishment of nomogram prediction model
摘要
Abstract
Objective To investigate the risk factors for the occurrence of dominant aspiration in ICU adult inpatients,and to establish a nomogram prediction model.Methods A total of 1173 ICU inpatients were selected,and they were randomly assigned to modeling group(n=821)or validation group(n=352)in a ratio of 7∶3.According to the presence of dominant aspiration,the modeling group was further assigned to aspiration group or non-aspiration group.The multivariate Logistic regression model was used to analyze the risk factors for the occurrence of dominant aspiration in ICU adult inpatients,and a nomogram prediction model was established based on the risk factors.The receiver operating characteristic curve,calibration curve,and decision curve analysis were employed to evaluate the discrimination,calibration,and clinical effectiveness,respectively.Results A total of 196(16.71％)patients suffered from dominant aspiration.The results of multivariate Logistic regression analysis revealed that mechanical ventilation,gastric residual volume,intra-abdominal pressure,aspiration history,and vomiting were the independent risk factors for the occurrence of dominant aspiration in ICU adult inpatients(P＜0.05).When employing the nomogram prediction model for predicting the occurrence of dominant aspiration in ICU adult inpatients,areas under the curve of the modeling group and the validation group were 0.851 and 0.920,respectively.The calibration curve revealed that the predictive probability was basically consistent with the actual probability.The results of decision curve analysis indicated that when probabilities of threshold of internal and external validations were 0.201 and 0.164,the net benefits were favorably high.Conclusion The incidence rate of dominant aspiration in ICU adult inpatients is favorably high.Mechanical ventilation,gastric residual volume,intra-abdominal pressure,aspiration history,and vomiting are the independent risk factors for the occurrence of dominant aspiration in ICU adult inpatients.The nomogram prediction model established based on the aforementioned factors is helpful for clinical medical and nursing personnel to evaluate the occurrence risk of dominant aspiration in this population.关键词
显性误吸/重症监护病房/危险因素/预测模型/成人Key words
Dominant aspiration/Intensive Care Unit/Risk factors/Prediction model/Adults分类
医药卫生引用本文复制引用
王彩虹,刘霞琴,覃双文,陆秀红,李玲,黄德斌..成人ICU住院患者发生显性误吸的危险因素及列线图预测模型的构建[J].广西医学,2024,46(11):1662-1669,8.基金项目
南宁市青秀区科技计划项目(2018033) （2018033）
