硬膜外分娩镇痛后产时发热风险预测模型的建立与验证OA

Objective:To explore the influencing factors of postpartum fever after epidural analgesia,construct a risk prediction model,and verify its predictive effect,so as to provide guidance for the monitoring and management of the labor process.Method:A retrospective study was conducted,with 8 847 parturients included in the modeling group,including 896 cases in the fever group and 7 951 cases in the control group.The validation group included 2 212 parturients using the same inclusion criteria,including 246 cases in the fever group and 1 966 cases in the control group.Using univariate analysis and logistic regression to analyze the influencing factors of the fever group,establish a risk prediction model and draw a column chart.The Hosmer-Lemeshow test and ROC curve were used to validate the model.Result:In this study,six risk factors,namely ICP,BMI,duration from admission to delivery,duration of epidural labor analgesia,birth weight and NLR,are ultimately included to construct a risk prediction model.The area under the ROC curve of the modeling group is 0.730,the 95%CI is 0.713 to 0.746,the optimal cut-off value is 0.088,the sensitivity is 0.632,and the specificity is 0.707.The results of external validation through R language show that the area under the ROC curve(AUC)of the validation group is 0.731,the 95%CI is 0.700～0.762,the optimal cut-off value is 0.088,the sensitivity is 0.610,and the specificity is 0.714.Conclusion:BMI,the duration from admission to delivery,duration of epidural analgesia during delivery,estimated weight of the newborn,and NLR are risk factors for fever after epidural analgesia during delivery.The risk prediction model constructed in this study has good performance and can provide guidance for predicting fever during labor.