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空军军医大学第一附属医院心血管外科,陕西 西安 710032
吕向妮,E-mail:xjyy112233@163.com
收稿:2026-01-23,
修回:2026-09-18,
录用:2026-04-16,
纸质出版:2026-10-25
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段艳子,吕向妮.感染性心内膜炎患者术后ICU停留时间延长的影响因素及列线图模型构建[J].局解手术学杂志,2026,35(10):901-905.
DUAN Yan-zi,LYU Xiang-ni.Risk factors for prolonged ICU duration after surgery in patients with infective endocarditis and construction of a nomogram model[J].JOURNAL OF REGIONAL ANATOMY AND OPERATIVE SURGERY,2026,35(10):901-905.
段艳子,吕向妮.感染性心内膜炎患者术后ICU停留时间延长的影响因素及列线图模型构建[J].局解手术学杂志,2026,35(10):901-905. DOI: 10.11659/jjssx.01E026146.
DUAN Yan-zi,LYU Xiang-ni.Risk factors for prolonged ICU duration after surgery in patients with infective endocarditis and construction of a nomogram model[J].JOURNAL OF REGIONAL ANATOMY AND OPERATIVE SURGERY,2026,35(10):901-905. DOI: 10.11659/jjssx.01E026146.
目的
2
探讨感染性心内膜炎(IE)患者术后ICU停留时间延长的影响因素并构建列线图模型。
方法
2
回顾性纳入2023年2月至2025年2月于我院心血管外科进行手术治疗的IE患者210例,根据其术后ICU停留时间是否超过72 h分为非延长组(≤72 h,151例)和延长组(>72 h,59例)。采用Logistic回归分析IE患者术后ICU停留时间延长的独立危险因素,并根据筛选出的影响因素构建列线图模型,采用受试者工作特征曲线、校准曲线、决策曲线分析(DCA)评估预测模型的准确性。
结果
2
Logistic多因素结果显示:术前左室射血分数(LVEF)
<
60%、使用主动脉内球囊反搏泵(IABP)、机械通气时间
>
24 h、肌酐水平过高、栓塞是IE患者术后ICU停留时间延长的独立危险因素。列线图模型的曲线下面积(AUC)为0.985(95%
CI
:0.965~1.000),敏感度为0.971,特异度为0.955。校准曲线的实际概率与预测概率有较高的一致性。DCA显示:该模型在预测IE患者术后ICU停留时间延长方面具有较高临床效能。
结论
2
术前LVEF<60%、使用IABP、机械通气时间>24 h、肌酐水平过高、栓塞是IE患者术后ICU停留时间延长的独立危险因素,基于这些因素构建的列线图模型的预测价值较高。
Objective
2
To investigate the risk factors for prolonged ICU duration after surgery in patients with infective endocarditis (IE) and to construct a nomogram model.
Methods
2
A total of 210 patients with IE who underwent surgery in the Department of Cardiovascular Surgeryat our hospital from February 2023 to February 2025 were retrospectively included and divided into the non‑prolonged group (≤72 hours,151 cases) and the prolonged group (>72 hours,59 cases) based on whether their ICU duration exceeded 72 hours after surgery.Logistic regression analysis was performed to identify the independent risk factors for prolonged ICU duration after surgery in patients with IE. A nomogram model was constructed based on the identified risk factors, and the predictive accuracy of the model was evaluated by receiver operating characteristic curve, calibration curve, and decision curve analysis (DCA).
Results
2
Multivariate Logistic regression analysis showed that preoperative left ventricular ejection fraction (LVEF)
<
60%, use of intra‑aortic balloon pump (IABP), mechanical ventilation duration
>
24 hours, elevated creatinine level, and embolism were the independent risk factors for prolonged ICU duration after surgery in patients with IE.The area under the curve (AUC) of the nomogram model was 0.985 (95%
CI
:0.965 to 1.000),with a sensitivity of 0.971 and a specificit
y of 0.955.The calibration curve showed high consistency between the predicted and actual probabilities.DCA indicated that the model had high clinical utility in predicting prolonged ICU duration after surgery in patients with IE.
Conclusion
2
Preoperative LVEF < 60%, use of IABP, mechanical ventilation duration > 24 hours, elevated creatinine level, and embolism were the independent risk factors for prolonged ICU duration after surgery in patients with IE, and the nomogram model constructed based on these factors demonstrated high predictive value.
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