Construction and validation of a risk prediction model for prolonged mechanical ventilation in adult heart transplant recipients
10.3760/cma.j.cn115682-20221018-05055
- VernacularTitle:成人心脏移植受者术后机械通气时间延长风险预测模型的构建及验证
- Author:
Yonggang LI
1
;
Feifei ZHUANG
;
Rong WU
;
Yanni HUO
;
Yujia HUANG
;
Mingjing ZHAO
;
Chen ZHANG
Author Information
1. 中国医学科学院阜外医院成人外科恢复室一区，北京 100030
- Keywords:
Heart transplantation;
Respiration, artificial;
Prolonged mechanical ventilation;
Risk factors;
Predictive model;
Postoperative evaluation
- From:
Chinese Journal of Modern Nursing
2023;29(12):1556-1562
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To establish a risk prediction model for prolonged mechanical ventilation in adult heart transplant recipients.Methods:This study used structured language to query hospital electronic medical record systems. From January 2004 to December 2021, 957 adult recipients undergoing cardiac transplantation at Fuwai Hospital of the Chinese Academy of Medical Sciences were selected as the study subject using a convenience sampling. This study collected basic information, past history, preoperative blood creatinine, preoperative total bilirubin, preoperative ventilation assistance, and intraoperative donor heart cold ischemia time. The enrolled patients were divided into a training group ( n=717) and a validation group ( n=240) in a ratio of 3∶1. Based on the training group data, a risk prediction model was constructed using two-way stepwise Logistic regression. The prediction performance of the model was evaluated using the area under the receiver operating characteristic (ROC) curve, sensitivity and specificity based on the validation group data. Results:A total of 957 adult heart transplant recipients were included, and 18.39% (176/957) of them experienced prolonged mechanical ventilation (>24 hours) after surgery. Based on the model established by the training group data, 7 independent risk factors for prolonged mechanical ventilation after surgery were clarified, including age ≥ 60 years old ( OR=1.820), history of blood transfusion ( OR=5.237), previous cardiac surgery ( OR=2.826), preoperative total bilirubin≥ 34.2 μmol/L ( OR=1.861), preoperative ventilator assistance ( OR=9.421), preoperative intra-aortic balloon pump assistance ( OR=1.826), intraoperative donor heart cold ischemia time≥ 360 min ( OR=2.093) ( P<0.05). The area under the curve of the model was 0.676 (95% confidence interval was 0.581 to 0.770), with a sensitivity of 0.500, and a specificity of 0.796. Conclusions:Based on the data of adult heart transplant recipients from a single center, this study established a relatively simple and objective risk prediction model that can predict the prolonged mechanical ventilation in adult heart transplant recipients, and has good clinical value.
