关键词: 老年人, 术中, 血糖异常, 列线图, 麻醉, 手术时间, 围手术期护理

Abstract:

To analysis the risk factors of intraoperative blood glucose abnormalities（dysglycemia） in elderly patients without diabetes，and to develop a nomogram risk prediction model. Methods Convenience sampling was conducted in elderly patients aged ≥ 65 years without diabetes who received surgical treatment. Univariate analysis and binary logistic regression analysis were used to determine the risk factors of intraoperative blood glucose abnormalities，establish a risk prediction model and draw a nomogram. Receiver Operating Characteristic（ROC） and Hosmer-Lemeshow tests were used to verify the predictive effect of the model，and Bootstrap method was used for internal validation. Results The logistic regression analysis showed that type of anesthesia，duration of surgery，baseline operating room blood glucose level，and age were independent predictors of intraoperative dysglycemia. The predictive formula for intraoperative dysglycemia was established as follows：Logit P=-12.810+0.066 × age +1.966 × baseline operating room blood glucose level +0.008 × duration of surgery -2.778 × type of anesthesia. The area under the ROC curve was 0.815，and the optimal critical value boundary was 0.765. The sensitivity and specificity were 83.00% and 67.00%，respectively. The result of Hosmer-Lemeshow test was χ²=5.557（P=0.697）. The prediction curve fit well with the ideal curve，suggesting that the model has good predictive ability. External validation showed that the sensitivity of the model was 77.01%，the specificity was 75.36%，and the overall accuracy was 76.56%. Conclusion The prediction model constructed in this study has a good effect，which can provide a reference for clinical evaluation of the risk of abnormal blood glucose in elderly patients without diabetes.

Key words: Aged, Intraoperative, Dysglycemia, Nomogram, Anesthesia, Duration of Surgery, Periope-rative Nursing