住院病人鼻肠管非计划拔管风险预测模型的构建与验证OA

Objective:To construct and validate a risk prediction model for unplanned extubation in patients with nasojejunal tube,so as to provide reference for early identification of highrisk individuals by medical staff.Methods:A total of 280 patients with nasojejunal tubes who were hospitalized in a tertiary grade A hospital in Xining City from January 2022 to September 2024 were selected as the research subjects by using the purity-based sampling method.The research subjects were randomly divided into the training set(n=196)and the validation set(n=84)in a 7∶3 ratio using the random number method of R software.They were divided into the extraction group and the non-extraction group according to whether the nasojejunal tube was extracted.LASSO regression,univariate and multivariate Logistic regression analysis were used to screen risk factors,construct predictive models,and draw visual Nomograms.The performance of the model was evaluated by using the receiver operating characteristic(ROC)curve,Hosmer-Lemeshow test,correction curve,decision curve analysis(DCA),and clinical impact curve(CIC).Results:Logistic regression analysis showed that the patient's age,the professional title of the responsible nurse,the material of the catheter and the indwelling time were independent risk factors for unplanned extubation in patients with nasoenteric tubes(P＜0.05).The area under the ROC curve of the training set was 0.81,the sensitivity was 64％,and the specificity was 88％.The Hosmer-Lemehow test(x2=4.824,P=0.776 2)and the correction curve indicated that the model had good calibration.The clinical decision curve analysis indicated that net clinical benefits could be obtained,and the clinical impact curve indicated high clinical predictive efficacy.Conclusions:The patient's age,the professional title of the responsible nurse,the material of the catheter and the indwelling time are the influencing factors of unplanned extubation of nasoenteric tubes in inpatients.The model constructed based on this has good discrimination and calibration,which can provide reference for clinical medical staff to screen high-risk groups of unplanned extubation of nasoenteric tubes.