自發(fā)性腦出血病人搶救性氣管插管風險預(yù)測模型的構(gòu)建與驗證
AbstractObjective:Toanalyzetheriskfactorsofemergencyendotrachealintubationinpatientswithspontaneousintracerebral hemorhage,ndtoconstructaiskpredictionmodel,andvrifyitMethods:Atotalof89patientswithspontaneousitracerebal hemorrageodmiedtoteemergencydepartentinatertiarygdeAospitalfroptember18tuary3,wee selectedasubjects.Acodingtothechronologicaloder,theyweredividedntoamodelinggroup(290cases)andavalidationgroup(99 cases).TheLASSOregresionwasusedtoscreentheinfluencingfactorsofemergencyendotrachealintubationinpatientswith spontaneous intracerebralhemorrageAndtheLogisticriskpredictionmodelwasconstructed.Theareaunderthereceiveroperating characteristiccurve(ROC),calibrationcurve,Hosmer-Lemeshowtest,anddecisioncurve(DCA)wasusedtoverifythemodel.Results: Emergency endotracheal intubation occurred in 54 patients (18.6% )with spontaneous intracerebral hemorrhage in modeling group. MultivariateLgistcegialissultsodtattgaustedaomobididC)igsel time,hearrate,xygesaturatin,odiiedEarlyWaigScaleMEWS)iameteroftelftpupil,ghtrflexoftelftpil,d lightreflexofthtpupileeteifluencingfctorsfomergecyndotachalnubatioipatietswitsontaneousitracebal hemorrhage.The area under the ROC curve in the modeling group was 0.906(95%CI 0.867-0.946) .The optimal cut-off value of the model prediction was O.l22,witha sensitivityof 94.4% ,aspecificityof 74.6% .TheYoudenindexwasO.69o.Hosmer-Lemeshowtest results showed that χ2=8.91 P=0.350 .The calibration curve had a high degree of coincidence with the reference line.The clinical decisioncurveindicatedthatthemodelhadgoodclinicaldecision-makingperformance.Conclusions:Theriskpredictionmodel constructedinthisstudycouldbettepredicttheoccurenceofemergencyendotrachealintubationinpatientswithspontaneous intracerebralhemorhage,providingreferenceforclinicalmedicalstafftoidentifythehigh-riskpopulationrequiringemergncy endotracheal intubation as earlyas possibleand formulate targeted interventions.
Keywords spontaneous intracerebral hemorhage;emergency endotracheal intubation;influencing factors;predictionmodels; LASSO regression
摘要目的:分析自發(fā)性腦出血病人搶救性氣管插管的危險因素,構(gòu)建風險預(yù)測模型,并對其進行驗證。(剩余12645字)
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