無痛気管支鏡検査後の発熱のリスク予測モデルの構築

Construction of a Risk Prediction Model for Fever After Painless Bronchoscopy.

• Zhang-Hong Lv
• Niu Yuan

抄録

背景 本研究の目的は、無痛気管支鏡検査後の発熱のリスク予測モデルを構築することであった。材料および方法 計188人の患者を対象とし、自分でデザインしたデータ収集フォームを使用した。無痛気管支鏡検査前、検査中、検査後の患者の関連する臨床データを収集し、一変量解析により影響因子を分析し、重ロジスティック回帰分析により予測式を構築し、ROC曲線分析により検定した。結果 無痛気管支鏡検査を受けた188例のうち、術後発熱は49例で、発症率は26.0％であった。予測確率モデルはP=e"Lm_2E3"/1+e"Lm_2E3"、eは自然対数、X=-4.337+0.020×（CRP）+1.014（検査時間が30分以上かどうか）+1.912×（麻酔時にレミフェンタニルを使用したかどうか）+1.514×（手術中または回復期に悪心・嘔吐があったかどうか）であった。予測感度と特異度はそれぞれ78.26% 76.72%であった。結論 この無痛気管支鏡検査後の発熱リスク予測モデルを用いることで、術後発熱リスクの高い人の認識を改善することができ、臨床看護観察や無痛気管支鏡検査後の発熱の早期スクリーニングの指針とすることができる。

BACKGROUND The aim of this study was to construct a risk prediction model for fever after painless bronchoscopy. MATERIAL AND METHODS A total of 188 patients were included, and a self-designed data collection form was used. By collecting relevant clinical data of patients before, during, and after the painless bronchoscopy, the influencing factors were analyzed through univariate analysis, and multiple logistic regression analysis was performed to construct the prediction equation, which was tested by ROC curve analysis. RESULTS Of the 188 patients undergoing painless bronchoscopy, 49 had postoperative fever, and the incidence rate was 26.0%. The prediction probability model was: P=eˣ/1+eˣ, where e is the natural logarithm, X=-4.337+0.020×(CRP)+1.014 (whether the examination time was greater than 30 minutes)+1.912×(whether remifentanil was used during anesthesia)+1.514×(whether nausea or vomiting occurred during surgery or during recovery). The prediction sensitivity and specificity were 78.26% 76.72%, respectively. CONCLUSIONS Use of this risk prediction model of fever after painless bronchoscopy can improve the recognition of people at high risk of postoperative fever, and it has good ability to guide clinical nursing observation and early screening of fever after painless bronchoscopy.