预测选择性心脏手术合并体外循环后多器官功能衰竭和急性肾损伤的Nomogram M效度评估

L. Berikashvili, A. V. Smirnova, E. A. Laricheva, Nadezhda D. Gracheva, Kristina K. Kadanceva, Mihail Ya. Yadgarov, A. Grechko
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摘要

目的。探讨M图对择期心脏手术合并体外循环术后多器官功能衰竭(MOF)和急性肾损伤(AKI)的预测价值。材料和方法。这是一项回顾性队列研究。采用roc分析评价M图对择期心脏手术合并体外循环术后多器官功能衰竭和急性肾损伤的预测价值。结果。样本量为158例。AKI发生率为5.7%(158例患者中有9例)。MOF的发生率为3.8%(6 / 158)。AKI的AUC图M为0.714 [95% CI: 0.555-0.874] (p=0.031);临界值为12.5点;敏感性为66.67%,特异性为82.55%;优势比为9.46 (95% CI: 2.22 ~ 40.30) (p<0.001)。MOF的AUC图M为0.770 [95% CI: 0.594-0.946] (p=0.025);临界值为12.5点;敏感性为83.33%,特异性为82.24%;优势比为23.15 (95% CI: 2.60 ~ 206.20) (p<0.001)。结论。根据roc分析结果,Nomogram M对于选择性心脏手术合并体外循环后多器官功能衰竭和急性肾损伤具有可接受的预测价值。
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Nomogram M validity assessment for predicting multiple organ failure and acute kidney injury after elective cardiac surgery with cardiopulmonary bypass
Purpose. To evaluate the predictive value of nomogram M for multiple organ failure (MOF) and acute kidney injury (AKI) after elective cardiac surgery with cardiopulmonary bypass. Materials and methods. This was a retrospective cohort study. The predictive value of nomogram M for multiple organ failure and acute kidney injury after elective cardiac surgery with cardiopulmonary bypass was evaluated using ROC-analysis. Results. The sample size was 158 patients. The incidence of AKI was 5.7% (9 of 158 patients). The incidence of MOF was 3.8% (6 of 158 patients). AUC nomogram M for AKI was 0.714 [95% CI: 0.555–0.874] (p=0.031); the cut-off value was 12,5 points; the sensitivity was 66.67% and specificity was 82.55%; the odds ratio was 9.46 (95% CI: 2.22–40.30) (p<0.001). AUC nomogram M for MOF was 0.770 [95% CI: 0.594–0.946] (p=0.025); the cut-off value was 12,5 points; the sensitivity was 83.33% and specificity was 82.24%; the odds ratio was 23.15 (95% CI: 2.60–206.20) (p<0.001). Conclusion. Nomogram M has an acceptable predictive value for multiple organ failure and acute kidney injury after elective cardiac surgery with cardiopulmonary bypass based on the results of the ROC-analysis.
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