基于中国人群的声门暴露困难预测模型的前瞻性研究OA

Objective To construct a simplified predictive model for difficult laryngeal exposure(DLE)during laryngomicrosurgery in Chinese population and evaluate its clinical value.Methods A total of 384 patients with laryngomicrosurgery from January 2022 to December 2023 were selected.DLE was defined as Cormack-Lehane grades Ⅲ to Ⅳ.Univariate analysis and multivariate Logistic regression were used to screen independent risk factors.A predictive model was constructed incorporating 5 pa-rameters:body mass index(BMI)≥28 kg/n2,neck circumference ≥40 cm,thyromental distance＜6.5 cm,modified Mallampati classification grades Ⅲ to Ⅳ,and moderate-to-severe restriction of neck mobility.The area under the curve(AUC)of the receiver operating characteristic(ROC)curve and the Bootstrap method were employed to validate the performance of the model.Results The model demonstrated a negative predictive value of 95.3％,good discriminatory performance(AUC=0.876,95％ CI,0.835 to 0.917),and stable internal validation(adjusted AUC=0.862).When the cut-off value was ≥3 points,the model exhibited a sensitivity of 86.0％ and a specificity of 82.6％.Con-clusion This model can accurately identify patients at high risk of DLE before surgery,providing a reference for individualized surgical preparation.