A Predictive Nomogram for Intensive Care-Acquired Weakness after Cardiopulmonary Bypass.

IF 1.1 4区 医学 Q4 CARDIAC & CARDIOVASCULAR SYSTEMS
Fuxiu Zhong, Haoruo Zhang, Yanchun Peng, Xueying Lin, Liangwan Chen, Yanjuan Lin
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引用次数: 0

Abstract

Purpose: Intensive care unit-acquired weakness (ICUAW) affects patient prognosis after cardiopulmonary bypass (CPB) surgery, but its risk factors remain unclear. We investigated these risk factors and developed a nomogram for predicting ICUAW after CPB.

Methods: Baseline characteristics, preoperative laboratory data, and intra- and postoperative variables of 473 patients after CPB were determined in this prospective cohort study. Lower limb muscles on bedside ultrasound images were compared 1 day before and 7 days after CPB. Risk factors were assessed using logistic regression models.

Results: Approximately 50.95% of the patients developed ICUAW after CPB. The body mass index (BMI), New York Heart Association (NYHA) class, lactate, albumin, aortic clamping time, operation time, and acute physiological and chronic health evaluation II were determined as independent risk factors. The average absolute error of coincidence was 0.019; the area under the curve, sensitivity, and specificity were 0.811, 0.727, and 0.733, respectively, for the predictive nomogram.

Conclusion: A high BMI, poor NYHA class, preoperative high serum lactate, low serum albumin, long surgical duration, aortic clamping, and high acute physiological and chronic health evaluation II score are risk factors for ICUAW after CPB. This robust and easy-to-use nomogram was developed for clinical decision-making.

心肺搭桥术后重症监护引起的虚弱的预测提名图。
目的:重症监护室获得性乏力(ICUAW)会影响心肺旁路(CPB)手术后患者的预后,但其风险因素仍不清楚。我们对这些风险因素进行了调查,并制定了预测 CPB 术后 ICUAW 的提名图:这项前瞻性队列研究确定了 473 名 CPB 患者的基线特征、术前实验室数据以及术中和术后变量。对 CPB 术前 1 天和术后 7 天床旁超声图像上的下肢肌肉进行了比较。使用逻辑回归模型评估了风险因素:结果:约 50.95% 的患者在 CPB 后出现 ICUAW。体重指数(BMI)、纽约心脏病协会(NYHA)分级、乳酸、白蛋白、主动脉夹闭时间、手术时间以及急性生理和慢性健康评估 II 被确定为独立的风险因素。重合的平均绝对误差为 0.019;预测提名图的曲线下面积、灵敏度和特异性分别为 0.811、0.727 和 0.733:结论:体重指数高、NYHA 分级低、术前血清乳酸高、血清白蛋白低、手术时间长、主动脉夹闭、急性生理和慢性健康评估 II 评分高是 CPB 后发生 ICUAW 的危险因素。这一可靠且易于使用的提名图是为临床决策而开发的。
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来源期刊
Annals of Thoracic and Cardiovascular Surgery
Annals of Thoracic and Cardiovascular Surgery CARDIAC & CARDIOVASCULAR SYSTEMS-SURGERY
CiteScore
2.80
自引率
0.00%
发文量
56
审稿时长
4-8 weeks
期刊介绍: Information not localized
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