鼻饲患者两种误吸风险预测模型的外部验证及比较

doi:10.3761/j.issn.0254-1769.2021.09.012

摘要/Abstract

摘要：

目的对该研究团队前期构建的鼻饲患者误吸风险预测列线图和分类回归树开展外部验证,评估模型的临床适用性及有效性。方法采用便利抽样法,选取重庆市某三级甲等医院2019年7月—2020年7月收治的鼻饲患者作为研究对象,根据是否发生误吸分为误吸组和非误吸组,绘制受试者工作特征曲线评价两种模型的性能。结果鼻饲患者误吸风险预测列线图和分类回归树的受试者工作特征曲线下面积分别为0.91（95%CI为0.89~0.98）和0.92（95%CI为0.91~0.95）,灵敏度分别为89.2%和64.9%,特异度分别为89.7%和96.6%,预测准确率分别为89.6%和89.0%。结论该研究团队前期构建的鼻饲患者误吸风险预测列线图和分类回归树均能有效预测鼻饲患者的误吸风险,分类回归树的预测性能略优于列线图。

关键词: 肠道营养, 误吸, 风险管理, 预测模型, 护理

Abstract:

Objective To externally validate the Classification and Regression Tree and the Nomogram model for risk prediction in patients receiving nasogastric feeding constructed in the earlier stage of this study,and to evaluate the clinical practicability and effectiveness of the 2 models. Methods Convenience sampling method was applied to collect the information of nasogastric feeding patients from July 2019 to July 2020 in a tertiary hospital of Chongqing. The patients were divided into an aspiration group and a non-aspiration group according to the incidence of aspiration. The ROC curves were drawn to evaluate the performance of the 2 models. Results The area under the ROC curves of the Nomogram and Classification and Regression Tree was 0.91（95%CI:0.89~0.98）and 0.92（95%CI:0.91~0.95）,respectively. The sensitivity,specificity and accuracy in 2 groups were 89.2% and 64.9%,89.7% and 96.6%,89.6% and 89.0%,respectively. Conclusion Both the Nomogram and the Classification and Regression Tree can predict the aspiration risk of nasogastric feeding patients effectively. The prediction performance of the Classification and Regression Tree is slightly better than that of the Nomogram.

Key words: Enteral Nutrition, Aspiration, Risk Management, Prediction Model, Nursing Care

孙文静, 谢莉玲, 黄龙贤, 游海玲, 屈芙蓉, 左燕. 鼻饲患者两种误吸风险预测模型的外部验证及比较[J]. 中华护理杂志, 2021, 56(9): 1352-1356.

SUN Wenjing, XIE Liling, HUANG Longxian, YOU Hailing, QU Furong, ZUO Yan. External validation and comparison of 2 aspiration risk prediction models in patients receiving nasogastric feeding[J]. Chinese Journal of Nursing, 2021, 56(9): 1352-1356.

图/表 4

图1 鼻饲患者误吸风险预测列线图

Figure 1 Nomogram for aspiration risk prediction in patients receiving nasogastric feeding

图2 鼻饲患者误吸风险预测分类回归树注:每个节点的首行代表疾病分类,0表示“非误吸”,1表示“误吸”;第2行代表误吸概率;第3行代表内部验证中该节点患者人数占总人数的百分比;蓝色节点表示具有更多的非误吸患者;绿色节点表示具有更多的误吸患者[7]。

Figure 2 Classification and Regression Tree for aspiration risk prediction in patients receiving nasogastric feeding

Table 1 Risk assessment results of the Classification and Regression Tree for aspiration risk prediction in patients receiving nasogastric feeding

图3 鼻饲患者两种误吸风险预测模型的受试者工作特征曲线

Figure3 ROC curves of two aspiration risk prediction models for patients receiving nasogastric feeding

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