Construction of a prediction model for difficult tracheal intubation in patients with obstructive sleep apnea-hypopnea syndrome
10.3760/cma.j.cn131073.20230111.00609
- VernacularTitle:阻塞性睡眠呼吸暂停低通气综合征患者困难气管插管预测模型的构建
- Author:
Junqing LI
1
;
Ning CAI
;
Dongfeng LIANG
;
Di WU
;
Guanghong CHEN
;
Hao YUAN
Author Information
1. 安徽医科大学附属阜阳医院麻醉科，阜阳 236000
- Keywords:
Sleep apnea, obstructive;
Intubation, intratracheal;
Forecasting;
Logistic models
- From:
Chinese Journal of Anesthesiology
2023;43(6):692-696
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To construct a prediction model for difficult tracheal intubation in the patients with obstructive sleep apnea-hypopnea syndrome (OSAHS).Methods:A total of 324 patients with OSAHS undergoing surgery with general anesthesia, admitted to our hospital from June 2019 to June 2021, were included in model group, and 175 patients with OSAHS undergoing surgery with general anesthesia, admitted from July 2021 to July 2022, were selected and served as validation group. The patients in model group were divided into occurrence group and non-occurrence group according to whether difficult tracheal intubation occurred. Logistic regression was used to construct the prediction model, and R4.2.1 software was used to draw the risk nomogram and calibration curve. The predictive accuracy of the model was evaluated by the area under the receiver operating characteristic curve.Results:Body mass index (BMI), sagittal minimum cross-sectional area, horizontal minimum cross-sectional area and mandibular distance were risk factors for difficult tracheal intubation in OSAHS patients ( P<0.05). A prediction model was developed using the above factors: Logit P=33.726+ 1.411×BMI score-0.014×sagittal airway minimum cross-sectional area-0.013×airway horizontal minimum cross-sectional area-0.312× mandibular distance. The area under the receiver operating characteristic curve was 0.846, Youden index 0.585, sensitivity 0.831, specificity 0.755, and the accuracy 0.889 (Hosmer-Lemeshow test χ2=9.24, P=0.322) in model group. The area under the external validation curve was 0.802, Youden index 0.545, sensitivity 0.636, specificity 0.908, and the accuracy 0.893 (Hosmer-Lemeshow test χ2=10.24, P=0.287) in validation group. Conclusions:The prediction model based on BMI, sagittal minimum cross-sectional area of airway, horizontal minimum cross-sectional area of airway and mandibular distance has a high value in predicting the risk of difficult tracheal intubation in patients with OSAHS.
