在针刺麻醉下接受消化道内窥镜检查的患者出现并发症的风险因素。

IF 16.4 1区化学 Q1 CHEMISTRY, MULTIDISCIPLINARY

Accounts of Chemical Research Pub Date : 2024-10-01 DOI:10.12669/pjms.40.9.10087

Haoliang Cai, Xiaohui Wu, Xi Chen, Jun Guo, Wenting Chen

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引用次数: 0

摘要

目的确定在针刺麻醉下接受消化道内镜检查的患者出现并发症的风险因素，并构建一个提名图预测模型：这项回顾性研究纳入了2020年6月至2023年5月期间在上海中医药大学附属曙光医院接受针灸麻醉下消化内镜检查的292例患者。采用逻辑回归分析法确定在针刺麻醉下接受消化内镜检查的患者出现并发症的风险因素。根据识别出的独立风险因素，使用R4.1.2软件的RMS包构建了一个提名图预测模型。使用一致性指数（C-index）、校准曲线和接收者操作特征曲线（ROC）评估了该模型的预测性能：75名患者（25.68%）出现并发症。体重指数（BMI）、心血管疾病史、空腹时间、呼吸系统疾病史和镇静-镇静量表（SAS）评分被确定为并发症的风险因素。根据这些风险因素，构建了一个提名图预测模型。提名图模型的 C 指数为 0.927。校准曲线显示实际观察结果与提名图预测结果之间具有良好的一致性。ROC 曲线下面积（AUC）为 0.927（95% CI：0.895-0.959），表明对并发症的发生有一定的预测价值。当选择最佳临界值时，模型的灵敏度和特异度分别为 77.0% 和 92.0%，表明该预测模型是有效的：结论：体重指数、心血管疾病史、空腹时间、呼吸系统疾病史和SAS评分是在针刺麻醉下接受消化内镜检查的患者出现并发症的独立风险因素。所构建的提名图预测模型在预测针刺麻醉下接受消化道内窥镜检查的患者发生并发症方面具有良好的性能。

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Risk factors for complications in patients undergoing gastrointestinal endoscopy under acupuncture anesthesia.

Objective: To identify risk factors for complications in patients undergoing gastrointestinal endoscopy under acupuncture anesthesia and to construct a nomogram predictive model.

Methods: This retrospective study included 292 patients who underwent gastrointestinal endoscopy under acupuncture anesthesia at the Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine from June 2020 to May 2023. Logistic regression analysis was used to identify risk factors for complications in patients undergoing gastrointestinal endoscopy under acupuncture anesthesia. A nomogram prediction model was constructed using the RMS package of R4.1.2 software based on the independent risk factors identified. The predictive performance of the model was assessed using consistency index (C-index), calibration curve, and receiver operating characteristic (ROC) curve.

Results: Seventy-five patients (25.68%) had complications. Body mass index (BMI), history of cardiovascular diseases, fasting time, history of respiratory diseases, and Sedation-Agitation Scale (SAS) score were identified as risk factors for complications. Based on this risk, a nomogram predictive model was constructed. The C-index of the nomogram model was 0.927. Calibration curve showed a good consistency between actual observations and nomogram predictions. The ROC curve area under curve (AUC) was 0.927 (95% CI: 0.895-0.959), indicating a certain predictive value for the occurrence of complications. When the optimal cut-off value was selected, the sensitivity and specificity of the model were 77.0% and 92.0%, respectively, indicating that the predictive model was effective.

Conclusions: BMI, history of cardiovascular disease, fasting time, history of respiratory disease, and SAS score are independent risk factors for complications in patients undergoing gastrointestinal endoscopy under acupuncture anesthesia. The constructed nomogram predictive model has a good performance in predicting the occurrence of complications in patients undergoing gastrointestinal endoscopy with under acupuncture anesthesia.

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来源期刊

Accounts of Chemical Research 化学-化学综合

CiteScore

31.40

自引率

1.10%

发文量

312

审稿时长

2 months

期刊介绍： Accounts of Chemical Research presents short, concise and critical articles offering easy-to-read overviews of basic research and applications in all areas of chemistry and biochemistry. These short reviews focus on research from the author’s own laboratory and are designed to teach the reader about a research project. In addition, Accounts of Chemical Research publishes commentaries that give an informed opinion on a current research problem. Special Issues online are devoted to a single topic of unusual activity and significance. Accounts of Chemical Research replaces the traditional article abstract with an article "Conspectus." These entries synopsize the research affording the reader a closer look at the content and significance of an article. Through this provision of a more detailed description of the article contents, the Conspectus enhances the article's discoverability by search engines and the exposure for the research.