摘要
目的:分析小儿术中获得性压力性损伤影响因素并构建风险预测模型。方法:采用便利抽样法,选取我院2020年1月—2021年4月手术患儿466例,收集患儿一般资料、实验室指标、手术相关资料及术中压力性损伤发生情况等数据,通过单因素分析筛选术中获得性压力性损伤发生的影响因素,利用Logistic回归构建风险预测模型,采用Hosmer⁃Lemeshow检验和受试者工作特征曲线下面积分别判断模型拟合优度和预测效果。结果:466例手术患儿中共有56例发生术中压力性损伤,发生率为12.0%;Logistic回归最终纳入风险预测模型的危险因素为术前Braden⁃Q评分、手术体位和手术时间;Hosmer⁃Lemeshow检验显示,P=0.482,受试者工作特征曲线下面积为0.811,约登指数为0.509,灵敏度为0.821,特异度为0.688,预测百分比为88.4%。结论:术前Braden⁃Q评分、手术体位和手术时间是小儿术中获得性压力性损伤发生的危险因素,构建的风险预测模型效果良好,可以为临床筛选高危患儿及采取针对性的预防保护措施提供参考。
Objective:To analyze the influencing factors of intraoperative acquired pressure injury in children and to construct a risk prediction model.Methods:A total of 466 children who underwent surgical treatment were selected by using the convenience sampling method from January 2020 to April 2021.Their general information,laboratory indicators,operation⁃related data and the occurrence of intraoperative pressure injuries were collected.Univariate analysis and multivariate Logistic regression were used to analyze the risk factors of intraoperative acquired pressure injury in children for risk prediction model construction.The goodness of fit and prediction effect of the model were verified by Hosmer⁃Lemeshow test and the area under ROC curve.Results:Intraoperative pressure injury occurred in 56 of 466 children,with an incidence of 12.0%.The risk factors finally included in the risk prediction model in Logistic regression were preoperative Braden⁃Q score,surgical position and operation time.Hosmer⁃Lemeshow test showed that P=0.482,the area under the ROC curve was 0.811,while the Youden index was 0.509,with sensitivity as 0.821 and specificity as 0.688,and the prediction percentage was 88.4%.Conclusions:Preoperative Braden⁃Q score,surgical position and operation time were the risk factors for the occurrence of intraoperative acquired pressure injury in children.The established risk prediction model has good effect,which can provide references for the clinical screening of high⁃risk children and the adoption of targeted preventive and protective measures.
作者
王震
张伟英
WANG Zhen;ZHANG Weiying(Tongji University School of Medicine,Shanghai 200092 China)
出处
《护理研究》
北大核心
2022年第13期2292-2297,共6页
Chinese Nursing Research
基金
上海市浦东新区卫生系统领先人才培养计划项目,编号:PWR12020⁃10
上海交通大学医学院护理学科人才培养计划项目,编号:jdhlrc202001。
关键词
小儿
术中获得性压力性损伤
影响因素
风险预测模型
调查研究
children
intraoperative acquired pressure injury
influencing factors
risk prediction model
investigation
