Develop a risk assessment system for unscheduled rehospitalisation within 3 months in patients of oral endrotracheal intubation
10.3969/j.issn.1671-8283.2025.07.006
- VernacularTitle:ICU经口气管插管患者3个月非计划再住院风险模型的构建
- Author:
Liang WANG
1
;
Haibo WANG
1
;
Wenjuan LI
1
;
Dandan LI
1
;
Guandong WANG
1
Author Information
1. 河南省人民医院呼吸与危重症医学科,河南省智慧护理与转化工程研究中心,河南省护理医学重点实验室,河南 郑州,450000
- Publication Type:Journal Article
- Keywords:
gray-level co-occurrence matrix;
rectus femoris muscle;
oral endotracheal intubation;
unscheduled rehospitalisation within 3 months;
risk assessment system;
ultrasound imaging;
critical ill patient
- From:
Modern Clinical Nursing
2025;24(7):44-53
- CountryChina
- Language:Chinese
-
Abstract:
Objective To identify predictive indicators for unscheduled rehospitalisation within 3 months in patients of oral endotracheal intubation(OEI)with ultrasound gray level co-occurrence matrix(GLCM)and develop a corresponding risk assessment system for the purpose to reduce the event of unscheduled rehospitalisation.Methods A total of 260 OEI patients who underwent extubation in a Tier-IIIA hospital between October 2023 and May 2024 were enrolled by convenience sampling.Patients were divided into a rehospitalisation group and a non-rehospitalisation group according to the event of unscheduled rehospitalisation within 3 months after discharge.Demographic data and laboratory test report,ultrasound morphological indicators and GLCM of rectus femoris muscle were collected on day-1 and day-7 after extubation.Multivariate logistic regression analysis and Framingham risk function were used to identify independent risk factors for unscheduled rehospitalisation within 3 months.A risk assessment system for unscheduled rehospitalisation within 3 months was subsequently developed.Predictive accuracy were evaluated using receiver operating characteristic(ROC)curve and area under the curve(AUC),and Hosmer-Lemeshow test.Results Toally 224 patients were included.The incidence of unplanned rehospitalization within 3 months in patients with oral tracheal intubation was 35.71%(80/224).The independent risk factors for unscheduled rehospitalisation within 3 months in OEI patients were identified as age≥60,nutrition risk screening2002≥3,shock index≥1.0,duration of mechanical ventilation≥251 hours,rectus femoris cross-sectional area≤1.41cm2,angular second moment≤0.71,the proportion change rate of ratio of rectus femoris on quadriceps femoeis for 0 on day-7 after extubation.The risk assessment system exhibited an AUC of 0.791(95%CI:0.707～0.875,P<0.001),with a sensitivity of 75.02%and a specificity of 67.33%.The Hosmer-Lemeshow value was 2.581(P=0.630),and the optimal cut-off value was determined at 3.Conclusion The developed risk assessment system demonstrates a satisfactory predictive performance.It provides a valuable reference for clinical assessment of the patients who had unscheduled rehospitalisation within 3 months in OEI patients.
