老年脑出血患者便秘的影响因素:对临床护理的启示

Biological research for nursing Pub Date : 2024-07-01 Epub Date: 2024-02-26 DOI:10.1177/10998004241229181
Meng Wang, Jue Lu, Ziwei Lu, Zhong Wang, Zhuo Wang, Chao Wu
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摘要

背景:便秘是老年脑出血住院患者的常见病。本研究旨在构建一个预测老年脑出血住院患者便秘风险的模型,为制定有针对性的干预措施提供参考。研究方法纳入2018年1月至2023年9月在苏州市某三甲医院神经外科接受治疗的老年脑出血患者。比较有便秘和无便秘患者的临床数据。采用Logistic回归分析探讨老年脑出血患者便秘的影响因素,并采用R软件构建折线图模型验证其预测效果。结果共纳入 504 例老年脑出血患者。老年脑出血患者便秘的发生率为 63.9%。逻辑回归分析显示,GCS 评分(OR = 1.094,95%CI:1.019∼1.174)、高血压(OR = 2.911,95%CI:1.797∼4.715)、使用脱水剂(OR = 3.794,95%CI:2.337∼6.158)、手术治疗(OR = 3.986,95%CI:2.339∼6.793)、使用镇静药物(OR=4.212,95%CI:2.386∼7.435)和肢体瘫痪(OR=6.313,95%CI:3.689∼10.803)是老年脑出血患者便秘的独立危险因素。预测模型的 ROC 曲线下面积为 0.872(95%CI:0.8401∼0.9033),最佳临界值为 0.705,灵敏度为 0.748,特异性为 0.857。结论老年脑出血患者便秘风险预测模型具有良好的区分度和校准性,有助于医护人员识别老年脑出血患者的便秘风险。
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Influencing Factors of Constipation in Elderly Patients With Intracerebral Hemorrhage: Implication for Clinical Care.

Background: Constipation is common in elderly inpatients with intracerebral hemorrhage. This study aimed to construct a model for predicting the risk of constipation in elderly inpatients with intracerebral hemorrhage and to provide reference for formulating targeted intervention measures. Methods: Elderly patients with intracerebral hemorrhage who were treated in the department of Neurosurgery of a third-class hospital in Suzhou from January 2018 to September 2023 were included. Clinical data of patients with and without constipation were compared. Logistic regression analysis was used to explore the influencing factors of constipation in elderly patients with intracerebral hemorrhage, and R software was used to construct a line chart model to verify its predictive effect. Results: A total of 504 elderly patients with intracerebral hemorrhage were included. The incidence of constipation in elderly patients with cerebral hemorrhage was 63.9%. Logistic regression analysis showed that GCS score (OR = 1.094, 95%CI: 1.019∼1.174), hypertension (OR = 2.911, 95%CI: 1.797∼4.715), use of dehydrating agent (OR = 3.794, 95%CI: 2.337∼6.158), surgical treatment (OR = 3.986, 95%CI: 2.339∼6.793), use of sedative drugs (OR = 4.212, 95%CI:2.386-7.435), and limb paralysis (OR = 6.313, 95%CI:3.689∼10.803) were the independent risk factors for constipation in elderly patients with intracerebral hemorrhage. The area under the ROC curve of the prediction model was 0.872 (95%CI: 0.8401∼0.9033), the best critical value was 0.705, the sensitivity was 0.748, and the specificity was 0.857. Conclusion: The constipation risk prediction model of elderly patients with cerebral hemorrhage has good differentiation and calibration, which is helpful for health care providers to identify the risk of constipation in elderly patients with intracerebral hemorrhage.

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