Modified paediatric preoperative risk prediction score to predict postoperative ICU admission in children: a retrospective cohort study

作者：Chunwei Lian, Pei Wang, Qingxia Fu, Xudong Du, Junzheng Wu, Qingquan Lian, Wang-Ning Shang-Guan · 发表于：BMJ Open · 年份：2020 · DOI：10.1136/bmjopen-2019-036008 · 被引用次数：6 · 研究领域：Cardiac, Anesthesia and Surgical Outcomes、Sepsis Diagnosis and Treatment、Enhanced Recovery After Surgery

OBJECTIVE: To integrate intrinsic surgical risk into the paediatric preoperative risk prediction score (PRPS) model to construct a more comprehensive risk scoring system (modified PRPS) and improve the prediction accuracy of postoperative intensive care unit (ICU) admission in paediatric patients. DESIGN: This was a retrospective study conducted between 1 January and 30 December 2016. Data on age, American Society of Anaesthesiology physical status (ASA-PS), oxygen saturation, prematurity, non-fasted status, severity of surgery and immediate transfer to the ICU after surgery were collected. The modified PRPS was developed by logistic regression in the derivation cohort; it was tested and compared with the paediatric PRPS and ASA-PS by the Hosmer-Lemeshow test, the receiver operating characteristic (ROC) curve and Kappa analysis in the validation cohort. SETTING: Hospital-based study in China. PARTICIPANTS: Paediatric patients (≤14 years) who underwent surgery under general anaesthesia were included, and those who needed reoperation due to surgical complications or stayed in the ICU preoperatively were excluded. MAIN OUTCOME MEASURE: ICU admission rate, defined as any patients' direct disposition from the operating room to the ICU immediately after the surgery. RESULTS: =6.84, p=0.077). The area under the ROC curve of the modified PRPS, paediatric PRPS and ASA-PS were 0.963, 0.941 and 0.870, respectively (p<0.05), and the Kappa values were 0.620, 0.286 and 0.267. Analyses in t...