主管:国家卫生健康委员会
主办:国家卫生健康委医院管理研究所
中国科技核心期刊(中国科技论文统计源期刊)
中国科学引文数据库(CSCD)核心库期刊
《中文核心期刊要目总览》核心期刊

中国护理管理 ›› 2019, Vol. 19 ›› Issue (12): 1833-1837.doi: 10.3969/j.issn.1672-1756.2019.12.015

• 谵妄管理专题 • 上一篇    下一篇

神经外科ICU患者谵妄预测模型的建立及验证

王军 纪媛媛 陈文劲 覃勤朴 肖倩 李淑兰   

  1. 首都医科大学宣武医院神经外科,100053北京市(王军,纪媛媛,陈文劲,覃勤朴);首都医科大学护理学院(肖倩,李淑兰)
  • 出版日期:2019-12-15 发布日期:2019-12-15
  • 作者简介:王军,硕士,主任护师,护理部副主任,科护士长,E-mail:wangj229@126.com
  • 基金资助:
    首都护理学研究专项重点课题(16HL05);2018年首都医科大学宣武医院院级护理专项课题(XWHL-2018006)

Establishment and validation of a delirium prediction model for neurosurgical patients in Intensive Care Unit

WANG Jun, JI Yuanyuan, CHEN Wenjin, QIN Qinpu, XIAO Qian, LI Shulan   

  1. Neurosurgery Department, Xuanwu Hospital Capital Medical University, Beijing, 100053, China
  • Online:2019-12-15 Published:2019-12-15

摘要: 目的:建立神经外科ICU患者谵妄预测模型并对模型的灵敏度和特异度进行验证。方法:采用前瞻性队列研究设计,收集某三级甲等医院神经外科ICU中2017年1月至2018年2月的310例患者临床资料,采用多因素Logistic回归建立谵妄预测模型,收集2018年3—6月60例患者的临床资料进行模型的验证。结果:310例患者中118例发生谵妄,谵妄发生率为38.1%;谵妄风险预测模型包括6个预测因子:入院认知功能障碍、发热、低蛋白血症、肝功能异常、使用镇静药物≥4次和使用身体约束;所建模型的ROC曲线下面积(AUC)为0.80±0.07(95%CI:0.674~0.932);模型灵敏度为0.68,特异度为0.83,临界值为0.51。结论:建立的神经外科ICU患者谵妄风险预测模型,预测效果良好,可以对患者谵妄发生风险进行早期预测,有助于医护人员早期识别谵妄高危人群。

关键词: 神经外科;ICU;谵妄;危险因素;风险预测模型

Abstract: Objective: To establish a delirium prediction model for neurosurgical ICU patients and verify the sensitivity and specificity of this model. Methods: A prospective cohort study was designed to collect data from 310 patients who were admitted to Neurosurgical ICU in a tertiary hospital from January 2017 to February 2018. A risk factor prediction model was then created using multivariate logistic regression. We further collected data from 60 patients between March and June 2018 to validate the model. Results: Among the 310 patients, there were 118 cases of delirium (38.1%). The model consisted of 6 predictors, which were cognitive dysfunction on admission, having fever, hypoproteinemia, abnormal liver function, sedative use ≥ 4 times, and physical restraint during the stay in ICU. The area under the curve (AUC) of the model was M=0.80, SD=0.07, 95% CI (0.674, 0.932). The sensitivity and specificity were 0.68 and 0.83, respectively, and the critical value was 0.51. Conclusion: The study established a delirium prediction model for neurosurgical ICU patients which consisted of 6 predictors. Our model can predict the risk of delirium in neurosurgical ICU patients, thereby helping medical staff to identify patients at high risk of delirium and implement targeted interventions to reduce the incidence of delirium and its negative effects.

Key words: neurosurgical; ICU; delirium; risk factors; prediction model

中图分类号: 

  • R47