局解手术学杂志2026，Vol.35Issue(2)：104-109,6.DOI:10.11659/jjssx.07E025110
小儿先天性心脏病术后心脏骤停预测模型的构建
Prediction model for cardiac arrest after surgery in pediatric congenital heart disease
王霜 1王筱君 1刘爱红 2沈正礼 1郝雪梅1
作者信息
- 1. 中国人民解放军总医院第七医学中心麻醉科,北京 100700
- 2. 中国人民解放军总医院第七医学中心儿童重症监护室,北京 100700
- 折叠
摘要
Abstract
Objective To analyze the influencing factors for postoperative cardiac arrest in children with congenital heart disease based on the baseline clinical data and ultrasomics.Methods A total of 993 pediatric patients with congenital heart disease who were admitted to our hospital from February 2020 to February 2025 were enrolled.They were categorized into the event group and the non-event group according to the occurrence of cardiac arrest within 30 days after surgery.Variables were initially screened using LASSO regression model,and subsequently analyzed using multivariate Logistic regression to identify the independent risk factors.A corresponding risk prediction model was established,and the model performance was validated using the receiver operating characteristic(ROC)curve and calibration curve.Results The incidence of cardiac arrest within 30 days after surgery was 5.14%.Five core variables were screened out by the LASSO regression model.Logistic regression analysis identified that risk adjustment for congenital heart surgery 1st version(RACHS-1)category≥4,longer cardiopulmonary bypass(CPB)time,greater early diastolic mitral inflow velocity/early diastolic mitral annular velocity(E/e'),and higher tricuspid regurgitation peak velocity(TR Vmax)were the independent risk factors for postoperative cardiac arrest(P<0.05),while a greater absolute value of left ventricular global longitudinal strain(LVGLS)was identified as a protective factor(P<0.05).A corresponding risk prediction model was established.The area under the curve(AUC)of the model for predicting postoperative cardiac arrest was 0.928,with a sensitivity of 92.16% and a specificity of 84.39%.The Hosmer-Lemeshow test indicated no significant difference between the predicted probability and actual probability for cardiac arrest after pediatric congenital heart disease surgery(χ²=0.415,P=0.296).Conclusion RACHS-1 category≥4,longer CPB time,a greater E/e'ratio,and a higher TR Vmax are the risk factors for cardiac arrest after pediatric congenital heart disease surgery,while a greater absolute value of LVGLS is a protective factor.The prediction model constructed by integrating the above baseline data and ultrasomics indicators demonstrates good performance.关键词
儿童/心脏病/心脏骤停/超声检查/列线图Key words
children/heart disease/cardiac arrest/echocardiography/nomogram分类
医药卫生引用本文复制引用
王霜,王筱君,刘爱红,沈正礼,郝雪梅..小儿先天性心脏病术后心脏骤停预测模型的构建[J].局解手术学杂志,2026,35(2):104-109,6.
