摘要
目的:分析颅脑损伤病人低钠血症的危险因素并建立Nomogram图预测模型,为颅脑损伤病人低钠血症提供可视化评估工具。方法:采用回顾性研究方法,回顾374例泰州市某三级医院神经外科出院病人资料,分析颅脑损伤后发生低钠血症的影响因素,运用R软件绘制Nomogram图,并以122例病人资料进行模型的外部验证。结果:374例病人中,发生低钠血症病人93例;多因素分析显示,合并脑挫伤(OR=2.773)、感染(OR=2.551)、高热(OR=5.109)、呕吐(OR=2.012)、使用脱水药(OR=3.024)、格拉斯哥昏迷评分法(GCS)评分≤8分(OR=7.530)是颅脑损伤病人发生低钠血症的危险因素。预测模型的Hosmer-Lemeshow检验结果为P=0.332,外部数据验证受试者工作特征(ROC)曲线下面积为0.817,约登指数最大值为0.57,最佳临界值为70分,灵敏度为0.828,特异度为0.742。结论:本研究构建的颅脑损伤病人低钠血症的预测模型可作为临床早期评估颅脑损伤发生低钠血症的评估工具。
Objective:To analyze the risk factors of hyponatremia in patients with craniocerebral injury and establish a Nomogram prediction model,so as to provide a visual evaluation tool for hyponatremia in patients with craniocerebral injury.Methods:The data of 374 patients discharged from neurosurgery department in a tertiary hospital were reviewed retrospectively.The influencing factors of hyponatremia after craniocerebral injury were analyzed.The Nomogram was drawn by R software,and the data of 122 patients were used for external verification of the model.Result:Among 374 patients,93 patients suffered from hyponatremia,the rate was 24.87%.Multivariate analysis showed that brain contusion(OR=2.773),infection(OR=2.551),high fever(OR=5.109),vomiting(OR=2.012),dehydration drugs(OR=3.024),GCS≤8(OR=7.530)were the influencing factors of hyponatremia in patients with craniocerebral injury.The Hosmer and Lemeshow Test result of the prediction model was P=0.332,and the area under ROC curve was 0.817,the maximum value of Jordan index was 0.57,the best critical value was 70,the sensitivity was 0.828,and the specificity was 0.742.Conclusion:The prediction model of hyponatremia in patients with craniocerebral injury constructed in this study can be used as an evaluation tool for early clinical evaluation of hyponatremia.
作者
朱红波
张伟
车彦军
李剑云
ZHU Hongbo;ZHANG Wei;CHE Yanjun;LI Jianyun(School of Medicine,Jiangsu University,Jiangsu 212000 China)
出处
《护理研究》
北大核心
2022年第17期3061-3065,共5页
Chinese Nursing Research
基金
中国学位与研究生教育研究项目,编号:C-YX20190201-08。
关键词
颅脑损伤
低钠血症
危险因素
预测
评估工具
craniocerebral injury
hyponatremia
risk factors
prediction
assessment tool
