Develop a risk prediction model for the patients with prolonged mechanical ventilation after coronary artery bypass grafting with extracorporeal circulation and its verification
10.3969/j.issn.1671-8283.2025.08.002
- VernacularTitle:体外循环下冠状动脉旁路移植术后患者机械通气时间延长风险预测模型的构建与验证
- Author:
Yonggang LI
1
;
Yan MA
;
Chen ZHANG
;
Yujia HUANG
;
Rong WU
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
- Publication Type:Journal Article
- Keywords:
prolonged mechanical ventilation;
coronary artery bypass grafting;
extracorporeal circulation;
prediction model
- From:
Modern Clinical Nursing
2025;24(8):9-16
- CountryChina
- Language:Chinese
-
Abstract:
Objective To develop a predictive model for assessment of the risk of the patients on prolonged mechanical ventilation after coronary artery bypass grafting with extracorporeal circulation.Methods A convenience sampling method was employed to select 2 334 patients who received the coronary artery bypass grafting(CABG)with extracorporeal circulation in our hospital from January 2021 to December 2023 as the study subjects.Preoperative,intraoperative and postoperative data were collected through structured queries from the electronic medical record system of hospital.The study subjects were randomly divided into a training set(n=1 633)and a validation set(n=701)following a 3:1 ratio.A risk prediction model was established using Logistic regression based on the training set data.Model fit was assessed using Hosmer-Lemeshow test,and predictive performance of the model was evaluated with the area under curve(AUC)of the receiver operating characteristic(ROC)curve.Results A total of 2,334 patients were included,of whom 215(9.2%)experienced the prolonged mechanical ventilation(>24 hours).The model developed from the training set identified seven factors that contributed to a prolonged mechanical ventilation:age(OR=1.03),body mass index(BMI,OR=1.14),time of extracorporeal circulation(OR=1.01),intraoperative blood transfusion(OR=4.15),postoperative serum total bilirubin(OR=1.08),postoperative serum albumin(OR=0.92)and postoperative re-sternotomy(OR=5.49).The AUC of the model for prediction of prolonged mechanical ventilation after CABG with extracorporeal circulation was 0.761,with a 95%CI of 0.716-0.806,a maximum Youden index of 0.105,a sensitivity of 77.94%,and a specificity of 64.38%.Validation using the validation set data yielded an AUC of 0.733,with a 95%CI of 0.662-0.804,a sensitivity of 75.32%,a specificity of 57.97%,and a predictive accuracy of 73.61%.Conclusion The risk prediction model developed in this study for prolonged mechanical ventilation after a CABG with extracorporeal circulation demonstrates a good predictive performance.It provides a reference for the nurses to identify the patient in high-risk of prolonged mechanical ventilation after a CABG with extracorporeal circulation and to implement preventive nursing measures.
