以质量求发展,以服务铸品牌

Journal of Nursing ›› 2023, Vol. 30 ›› Issue (20): 58-62.doi: 10.16460/j.issn1008-9969.2023.20.058

Previous Articles     Next Articles

Establishment of risk prediction model for intraoperative hypothermia in patients undergoing abdominal surgery of digestive system and its validation

FANG Min1,2, GAO Xing-lian1, KE Wen1, WANG Ceng-yan1, LIANG Yuan-yuan1,2   

  1. 1. Operating Room, Union Hospital, Tongji Medical College of Huazhong University of Science and Technology, Wuhan 430022, China;
    2. School of Nursing, Tongji Medical College of Huazhong University of Science and Technology, Wuhan 430030, China
  • Received:2023-06-27 Online:2023-10-25 Published:2023-11-08

Abstract: Objective To explore the factors influencing intraoperative hypothermia in patients undergoing abdominal surgery for digestive system, and to develop a risk prediction model and access its validity. Methods A total of 395 patients undergoing abdominal surgery for digestive system in our hospital from December 2021 to July 2022 were enrolled and allocated into hypothermia group (n=242)and non-hypothermia group(n=153) based on whether hypothermia occurred. The factors influencing intraoperative hypothermia were determined by logistic regression, and a risk prediction model was developed and plotted in a nomogramm, and the discrimination, calibration and clinical validity of the model were assessed. Result Four factors of the cleanliness of operating room, operation grade, anesthesia time and basic body temperature at the beginning of the operation were included in the model. When the best cut-off value of the model was 0.477, the area under the ROC curve was 0.901 with the sensitivity and the specificity of 0.793 and 0.830 respectively while the Youden index 0.623,showing that the prediction model was well differentiated. Hosmer-Lemeshow test showed χ2=3.938, P=0.863, indicating that prediction model was well calibrated. Decision curve analysis showed that the model has clinical effectiveness. Conclusion The constructed risk prediction model is of high value in predicting the occurrence of intraoperative hypothermia in patients undergoing abdominal surgery of digestive system. It provides reference for surgical team to take timely measures to prevent hypothermia for high-risk patients.

Key words: hypothermia, surgery of digestive system, influencing factor, risk prediction, nursing in operating room

CLC Number: 

  • R473.6
[1] Sessler DI,Lee KA,McGuire J.Isoflurane anesthesia and circadian temperature cycles in humans[J].Anesthesiology, 1991,75(6):985-989.DOI: 10.1097/00000542-199112000-00010.
[2] National Instituute for Health and Care Excellence.The management of inadvenent perioperative hypothermia in adults[EB/OL].(2018-08-29)[2023-03-09].http://www.nice.org.uk/guideance/cg65.
[3] Rauch S, Miller C, Brauer A, et al.Perioperative hypothermia-a narrative review[J]. Int J Environ Res Public Health, 2021,18(16):8749. DOI: 10.3390/ijerph18168749.
[4] Sessler DI.Perioperative thermoregulation and heat balance[J]. Lancet, 2016, 387(10038):2655-2664. DOI:10.1016/S0140-6736(15)00981-2.
[5] Ribeiro JC, Bellusse GC, Martins DF I, et al.Effect of perioperative hypothermia on surgical site infection in abdominal surgery: a prospective cohort study[J]. Int J Nurs Pract, 2021,27(4):e12934. DOI: 10.1111/ijn.12934.
[6] Cumin D, Fogarin J, Mitchell SJ, et al.Perioperative hypothermia in open and laparoscopic colorectal surgery[J]. ANZ J Surg,2022,92(5):1125-1131. DOI:10.1111/ans.17493.
[7] Sabbag IP, Hohmann FB, Assuncao M, et al.Postoperative hypothermia following non-cardiac high-risk surgery: a prospective study of temporal patterns and risk factors[J]. PLoS One, 2021,16(11):e259789. DOI:10.1371/journal.pone.0259789.
[8] 国家麻醉专业质量控制中心. 围术期患者低体温防治专家共识(2023版)[J]. 协和医学杂志, 2023,14(4):734-743. DOI: 10.12290/xhyxzz.2023-0266.
[9] Link T.Guidelines in practice: hypothermia prevention[J]. AORN J, 2020,111(6):653-666. DOI: 10.1002/aorn.13038.
[10] Chen HY, Su LJ,Wu HZ, et al.Risk factors for inadvertent intraoperative hypothermia in patients undergoing laparoscopic surgery: a prospective cohort study[J]. PLoS One,2021,16(9):e257816.DOI:10.1371/journal.pone.0257816.
[11] 余文静, 肖瑶, 胡娟娟, 等. 预防围手术期患者低体温的最佳证据总结[J]. 中华护理杂志, 2019,54(4):589-594. DOI: 10.3761/j.issn.0254-1769.2019.04.023.
[12] 柯稳, 高兴莲, 余文静. 成人术中低体温发生风险预测工具和风险因素深度研究进展[J]. 护士进修杂志, 2022,37(22):2066-2071. DOI: 10.16821/j.cnki.hsjx.2022.22.010.
[13] 甘泳江, 陆芸芸. 空气洁净技术与手术部位感染预防的研究进展[J]. 中国医院建筑与装备, 2018,19(2):98-101. DOI: 10.3969/j.issn.1671-9174.2018.02.016.
[14] 黄培培, 米元元, 吴白女, 等. 肿瘤患者术中非计划性低体温预防及管理的证据总结[J]. 护理学报, 2018,25(21):33-39. DOI: 10.16460/j.issn1008-9969.2018.21.033.
[15] Horosz B, Malec-Milewska M.Inadvertent intraoperative hypothermia[J]. Anaesthesiol Intensive Ther, 2013,45(1):38-43. DOI: 10.5603/AIT.2013.0009.
[16] Madrid E, Urrutia G, Roque IFM, et al. Active body surface warming systems for preventing complications caused by inadvertent perioperative hypothermia in adults[J]. Cochrane Database Syst Rev,2016,4(4):CD009016.DOI:10.1002/14651858.CD009016.pub2.
[17] 董涛. 老年腹部全身麻醉手术患者术中低体温的影响因素[J]. 中国老年学杂志, 2020,40(6):1228-1231. DOI:10.3969/j.issn.1005-9202.2020.06.036.
[18] 章明阳, 杜李百合, 罗小平, 等. 术前患者预保温的最佳证据总结[J]. 护理学报,2020,27(6):17-22. DOI:10.16460/j.issn1008-9969.2020.06.017.
[1] ZHENG Xiao-jing, YAN Hong-hong, LI Hui-jing, CHEN Si-juan, CHEN Xiu-mei. Construction and verification of risk prediction model for hypoglycemia with hepatocellular carcinoma [J]. Journal of Nursing, 2025, 32(4): 53-58.
[2] WEI Li, ZHAO Xing-ying, LIU Jia, HE Yu-xuan, CHEN Xiao-mei, YANG Xue, XIAN Ji-shu, YANG Yan-ni. Care burden of family caregivers of severe inpatients in neurosurgery department and its influencing factors [J]. Journal of Nursing, 2025, 32(2): 1-6.
[3] YANG Bei, YE Hong-fang, ZHANG Ning, XIANG Lu-wei, LU Shi-yu. Current status of physical activity and its influencing factors in elderly patients with type 2 diabetes [J]. Journal of Nursing, 2025, 32(2): 7-12.
[4] CAO Juan, LI Fang, YU Yue, DAI Li, YANG Dan-dan, LI Zhi-hua, XU Xin-yi, DAI Qi, CHEN Ke-yu. Construction and verification of risk prediction model for venous thromboembolism after esophageal cancer surgery [J]. Journal of Nursing, 2024, 31(8): 63-68.
[5] ZHOU Yue, ZHANG Jie, PAN Yu-fan, DAI Yu, SUN Yu-jian, XIAO Yi, YU Yu-feng. Prediction models for risk of acquired weakness in mechanically ventilated patients: a systematic review [J]. Journal of Nursing, 2024, 31(6): 56-61.
[6] HUANG Xin, YU Li-jun, ZHANG Er-ming, HA Li-na. Current status of energy intake in patients with stable COPD and its influencing factors [J]. Journal of Nursing, 2024, 31(5): 12-16.
[7] MOU Xiao-ling, CHEN Yu-qi, LIU Hai-yan, LI Min, DONG Min, HUANG Jia-jia, LI Xuan, CHEN Yu. Postoperative depression and its influencing factors among lung transplant recipients [J]. Journal of Nursing, 2024, 31(21): 7-11.
[8] YAO Yao, ZHANG Min, CHEN Yan, WANG Chun. Implementation difficulties of “Internet +” disability care service from perspective of user experience [J]. Journal of Nursing, 2024, 31(19): 1-7.
[9] JIANG Ning-ning. Construction and validation of nomogram predictive model for risk of hypothermia in patients undergoing continuous renal replacement therapy [J]. Journal of Nursing, 2024, 31(19): 65-72.
[10] WANG Li-ning, QI Na, BAI Feng-xin, LI Chao-nan, FANG Ting, LI Yang, ZHANG Hui. Father involvement during infancy and its influencing factors: a latent profile analysis [J]. Journal of Nursing, 2024, 31(19): 73-78.
[11] ZHANG Yi-fan, XU Xiao-xia, WANG Zi-jiao, LIU La-mei, LI Zhen-ying, MAO Zhen-xue. Latent categories of moral courage among nurses in oncology department and its influencing factors [J]. Journal of Nursing, 2024, 31(13): 7-11.
[12] KE Wen, GAO Xing-lian, YU Wen-jing, FANG Min, WANG Zeng-yan. Construction of nursing quality evaluation index system for prevention of perioperative hypothermia based on Structure-process-outcome model [J]. Journal of Nursing, 2024, 31(1): 1-6.
[13] SHI Ting-ting, LI Ting, HUANG You-peng, ZHAO Yuan, ZHU Xiao-li, ZHOU Meng-juan, CHEN Yun-mei. Risk prediction model of oteoporosis in patients with type 2 diabetes: a scoping review [J]. Journal of Nursing, 2024, 31(1): 52-57.
[14] ZHOU Meng-juan, ZHU Xiao-li, ZHANG Tai, DUAN Jian-feng, LUO Yu-mei, MA Wei-li, LU Han, SHI Ting-ting, YANG Yi-lin, LI Ting, CHA Yao-lei, ZHAO Yuan. Construction and verification of predictive model for prolonged length of stay in patients with non-severe acute pancreatitis [J]. Journal of Nursing, 2023, 30(9): 7-12.
[15] SUN Xiao-wei, WANG Yan, MIN Chun-yan, DUAN Fei, XIAO Jiang-qin. Status quo and influencing factors of life space in elderly patients with chronic obstructive pulmonary disease:a 322-case study [J]. Journal of Nursing, 2023, 30(8): 1-6.
Viewed
Full text


Abstract

Cited

  Shared   
No Suggested Reading articles found!