{"title":"0 ~ 6岁儿童术后肺部并发症风险预测Nomogram模型。","authors":"Qian Wang, Yanhong Li, Kuangyu Zhao, Zhiguang Ping, Jiaqiang Zhang, Jun Zhou","doi":"10.2147/RMHP.S507147","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Postoperative pulmonary complications (PPCs) in children are common. However, few models tailored specifically for children are available to identify risk factors for PPCs and enable preoperative interventions. This study aimed to identify independent risk factors for PPCs in children and establish a risk prediction model.</p><p><strong>Methods: </strong>The clinical data of pediatric patients aged 0-6 years with an American Society of Anesthesiologists (ASA) physical status of I or II, and had undergone surgery with mechanical ventilation at Henan Provincial People's Hospital between January 2020 and December 2021 were retrospectively reviewed. Univariate and multivariate logistic regression analyses were employed to identify risk factors for PPCs. The corresponding nomogram prediction model was constructed based on the regression coefficients. The receiver operating characteristic curve and calibration curve were used respectively to evaluate the discriminant validity and calibration of the prediction model.</p><p><strong>Results: </strong>Among 1545 patients included, 211 (13.4%) developed PPCs (156 of 1082 patients in the discovery cohort and 55 of 463 patients in the test cohort). In the multivariate logistic regression analysis, age (odds ratio [OR] 0.87, 95% confidence interval [CI] 0.79-0.96, <i>P</i>=0.007), mechanical ventilation time (OR 1.36, 95% CI 1.20-1.55, <i>P</i><0.001), airway device (OR 1.67, 95% CI 1.04-2.68, <i>P</i>=0.033), ASA physical status (OR 1.96, 95% CI 1.34-2.88, <i>P</i>=0.001), and type of surgery (the total effect, <i>P</i>=0.004) were identified as the independent risk factors for PPCs in the discovery cohort. The prediction model showed good discrimination and calibration performance in both the discovery and test cohorts. The corresponding area under the curve was 0.762 (95% CI: 0.722, 0.803) and 0.818 (95% CI: 0.760, 0.875), respectively.</p><p><strong>Conclusion: </strong>We identified age, ventilation device and duration, ASA physical status, and surgical site as independent risk factors for PPCs in children aged 0-6 years. The predictive model performed well and demonstrated a certain capability in predicting the risk of PPCs.</p>","PeriodicalId":56009,"journal":{"name":"Risk Management and Healthcare Policy","volume":"18 ","pages":"1085-1097"},"PeriodicalIF":2.7000,"publicationDate":"2025-03-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11963797/pdf/","citationCount":"0","resultStr":"{\"title\":\"A Risk Prediction Nomogram Model for Postoperative Pulmonary Complications in Children Aged 0-6 years.\",\"authors\":\"Qian Wang, Yanhong Li, Kuangyu Zhao, Zhiguang Ping, Jiaqiang Zhang, Jun Zhou\",\"doi\":\"10.2147/RMHP.S507147\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>Postoperative pulmonary complications (PPCs) in children are common. However, few models tailored specifically for children are available to identify risk factors for PPCs and enable preoperative interventions. This study aimed to identify independent risk factors for PPCs in children and establish a risk prediction model.</p><p><strong>Methods: </strong>The clinical data of pediatric patients aged 0-6 years with an American Society of Anesthesiologists (ASA) physical status of I or II, and had undergone surgery with mechanical ventilation at Henan Provincial People's Hospital between January 2020 and December 2021 were retrospectively reviewed. Univariate and multivariate logistic regression analyses were employed to identify risk factors for PPCs. The corresponding nomogram prediction model was constructed based on the regression coefficients. The receiver operating characteristic curve and calibration curve were used respectively to evaluate the discriminant validity and calibration of the prediction model.</p><p><strong>Results: </strong>Among 1545 patients included, 211 (13.4%) developed PPCs (156 of 1082 patients in the discovery cohort and 55 of 463 patients in the test cohort). In the multivariate logistic regression analysis, age (odds ratio [OR] 0.87, 95% confidence interval [CI] 0.79-0.96, <i>P</i>=0.007), mechanical ventilation time (OR 1.36, 95% CI 1.20-1.55, <i>P</i><0.001), airway device (OR 1.67, 95% CI 1.04-2.68, <i>P</i>=0.033), ASA physical status (OR 1.96, 95% CI 1.34-2.88, <i>P</i>=0.001), and type of surgery (the total effect, <i>P</i>=0.004) were identified as the independent risk factors for PPCs in the discovery cohort. The prediction model showed good discrimination and calibration performance in both the discovery and test cohorts. The corresponding area under the curve was 0.762 (95% CI: 0.722, 0.803) and 0.818 (95% CI: 0.760, 0.875), respectively.</p><p><strong>Conclusion: </strong>We identified age, ventilation device and duration, ASA physical status, and surgical site as independent risk factors for PPCs in children aged 0-6 years. The predictive model performed well and demonstrated a certain capability in predicting the risk of PPCs.</p>\",\"PeriodicalId\":56009,\"journal\":{\"name\":\"Risk Management and Healthcare Policy\",\"volume\":\"18 \",\"pages\":\"1085-1097\"},\"PeriodicalIF\":2.7000,\"publicationDate\":\"2025-03-29\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11963797/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Risk Management and Healthcare Policy\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.2147/RMHP.S507147\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2025/1/1 0:00:00\",\"PubModel\":\"eCollection\",\"JCR\":\"Q2\",\"JCRName\":\"HEALTH CARE SCIENCES & SERVICES\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Risk Management and Healthcare Policy","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.2147/RMHP.S507147","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2025/1/1 0:00:00","PubModel":"eCollection","JCR":"Q2","JCRName":"HEALTH CARE SCIENCES & SERVICES","Score":null,"Total":0}
A Risk Prediction Nomogram Model for Postoperative Pulmonary Complications in Children Aged 0-6 years.
Background: Postoperative pulmonary complications (PPCs) in children are common. However, few models tailored specifically for children are available to identify risk factors for PPCs and enable preoperative interventions. This study aimed to identify independent risk factors for PPCs in children and establish a risk prediction model.
Methods: The clinical data of pediatric patients aged 0-6 years with an American Society of Anesthesiologists (ASA) physical status of I or II, and had undergone surgery with mechanical ventilation at Henan Provincial People's Hospital between January 2020 and December 2021 were retrospectively reviewed. Univariate and multivariate logistic regression analyses were employed to identify risk factors for PPCs. The corresponding nomogram prediction model was constructed based on the regression coefficients. The receiver operating characteristic curve and calibration curve were used respectively to evaluate the discriminant validity and calibration of the prediction model.
Results: Among 1545 patients included, 211 (13.4%) developed PPCs (156 of 1082 patients in the discovery cohort and 55 of 463 patients in the test cohort). In the multivariate logistic regression analysis, age (odds ratio [OR] 0.87, 95% confidence interval [CI] 0.79-0.96, P=0.007), mechanical ventilation time (OR 1.36, 95% CI 1.20-1.55, P<0.001), airway device (OR 1.67, 95% CI 1.04-2.68, P=0.033), ASA physical status (OR 1.96, 95% CI 1.34-2.88, P=0.001), and type of surgery (the total effect, P=0.004) were identified as the independent risk factors for PPCs in the discovery cohort. The prediction model showed good discrimination and calibration performance in both the discovery and test cohorts. The corresponding area under the curve was 0.762 (95% CI: 0.722, 0.803) and 0.818 (95% CI: 0.760, 0.875), respectively.
Conclusion: We identified age, ventilation device and duration, ASA physical status, and surgical site as independent risk factors for PPCs in children aged 0-6 years. The predictive model performed well and demonstrated a certain capability in predicting the risk of PPCs.
期刊介绍：
Risk Management and Healthcare Policy is an international, peer-reviewed, open access journal focusing on all aspects of public health, policy and preventative measures to promote good health and improve morbidity and mortality in the population. Specific topics covered in the journal include:
Public and community health
Policy and law
Preventative and predictive healthcare
Risk and hazard management
Epidemiology, detection and screening
Lifestyle and diet modification
Vaccination and disease transmission/modification programs
Health and safety and occupational health
Healthcare services provision
Health literacy and education
Advertising and promotion of health issues
Health economic evaluations and resource management
Risk Management and Healthcare Policy focuses on human interventional and observational research. The journal welcomes submitted papers covering original research, clinical and epidemiological studies, reviews and evaluations, guidelines, expert opinion and commentary, and extended reports. Case reports will only be considered if they make a valuable and original contribution to the literature. The journal does not accept study protocols, animal-based or cell line-based studies.
求助内容：
应助结果提醒方式：
京公网安备 11010802042870号
