脑卒中吞咽障碍患者IOE风险评估及模型构建

doi:10.3969/j.issn.1673-9701.2024.13.005

科研成果详情

题名	脑卒中吞咽障碍患者IOE风险评估及模型构建
其他题名	IOE risk assessment and model construction in stroke patients with dysphagia
作者	蔡晓调1; 陆艳2
发表日期	2024-05-08
发表期刊	中国现代医生影响因子和分区
语种	中文
原始文献类型	学术期刊
关键词	脑卒中吞咽障碍间歇经口至食管管饲法风险评估预测模型
其他关键词	Stroke ; Dysphagia ; Intermittent oro-esophageal tube feeding ; Risk assessment ; Prediction model
摘要	目的探讨脑卒中吞咽障碍行间歇经口至食管管饲法（intermittentoro-esophagealtubefeeding,IOE）发生误吸的风险评估及模型构建。方法选取2020年1月至2022年12月温州医科大学附属第二医院就诊的脑卒中吞咽障碍行IOE的146例患者为研究对象，根据IOE后是否误吸将其分为未误吸组（117例）和误吸组（29例），收集患者的临床资料，采用多因素Logistic回归分析患者发生误吸的危险因素，并建立列线图预测模型，利用C指数进行区分度评价，校准曲线进行列线图拟合度检测。结果两组患者的脑卒中病史、误吸史、脑卒中部位、自主咳嗽、洼田饮水试验、美国国立卫生研究院卒中量表（National Institutes of Health stroke scale,NIHSS）评分、置管体位、置管深度比较差异均有统计学意义（P<0.05）；多因素Logistic回归分析结果显示，有脑卒中病史、有误吸史、脑卒中部位为脑干、洼田饮水试验4～5级、NIHSS评分高、侧卧位置管、置管深度低均是脑卒中吞咽障碍行IOE患者误吸的危险因素（P<0.05），自主咳嗽是脑卒中吞咽障碍行IOE患者误吸的保护因素（P<0.05）；列线图预测模型判断误吸风险的C指数为0.705(95%CI:0.591～0.857),Hosmer-Lemeshow检验模型的拟合度良好；受试者操作特征曲线结果显示列线图预测模型的曲线下面积为0.756，敏感度为75.42%，特异性为77.09%。结论脑卒中病史、误吸史、脑卒中部位、自主咳嗽、洼田饮水试验、NIHSS评分、置管体位、置管深度均是脑卒中吞咽障碍行IOE患者误吸的影响因素，模型构建成功，构建的模型有良好的区分度和拟合度。
其他摘要	Objective To investigate the risk assessment and model construction of intermittent oro-esophageal tube feeding(IOE)for stroke patients with dysphagia.Methods A total of 146 patients with stroke dysphagia who received IOE in the Second Affiliated Hospital of Wenzhou Medical University from January 2020 to December 2022 were selected as study objects.According to whether or not they were aspirated after IOE,they were divided into non-aspiration group(117 cases)and aspiration group(29 cases).Clinical data of patients were collected.Multivariate Logistic regression was used to analyze the risk factors of aspiration in patients,and a nomogram prediction model was established.The C-index was used for differentiation evaluation,and the calibration curve was used to detect the nomogram fit degree.Results There were statistically significant differences in stroke history,aspiration history,stroke site,spontaneous cough,Wada drinking water test,National Institutes of Health stroke scale(NIHSS)score,catheter placement position,and catheter depth between two groups(P<0.05).Multivariate Logistic regression analysis showed that stroke history,aspiration history,brain stem location of stroke,grade 4 to 5 of Wada drinking water test,high NIHSS score,lateral position tube,and low catheter depth were all risk factors for aspiration in IOE patients with dysphagia of stroke(P<0.05),spontaneous cough was a protective factor for aspiration in IOE patients with dysphagia of stroke(P<0.05).The C-index of nomogram prediction model to judge aspiration risk was 0.705(95%CI:0.591-0.857),and Hosmer-Lemeshow test model fit well.The receiver operating characteristic curve results showed that the area under the curve of nomogram prediction model was 0.756,the sensitivity was 75.42%,and the specificity was 77.09%.Conclusion Stroke history,aspiration history,stroke site,spontaneous cough,Wada drinking water test,NIHSS score,placement position,and placement depth were all influential factors for aspiration in IOE patients with stroke dysphagia.The model was successfully constructed,and the constructed model had good differentiation and fitting degree.
资助项目	浙江省温州市基础性公益科研项目（Y20220479）
ISSN	1673-9701
卷号	62 期号:13 页码:15-20
DOI	10.3969/j.issn.1673-9701.2024.13.005
页数	6
收录类别	CNKI ; 万方 ; 维普
URL	查看原文
引用统计
文献类型	期刊论文
条目标识符	https://kms.wmu.edu.cn/handle/3ETUA0LF/214784
专题	附属第二医院第二临床医学院、附属第二医院、育英儿童医院附属第二医院_康复科
通讯作者	蔡晓调
作者单位	1.温州医科大学附属第二医院康复科; 2.温州医科大学附属第二医院综合康复科
第一作者单位	附属第二医院; 第二临床医学院，附属第二医院、育英儿童医院; 康复科
第一作者的第一单位	附属第二医院
推荐引用方式 GB/T 7714	蔡晓调,陆艳. 脑卒中吞咽障碍患者IOE风险评估及模型构建[J]. 中国现代医生,2024,62(13):15-20.
APA	蔡晓调, & 陆艳. (2024). 脑卒中吞咽障碍患者IOE风险评估及模型构建. 中国现代医生, 62(13), 15-20.
MLA	蔡晓调,et al."脑卒中吞咽障碍患者IOE风险评估及模型构建".中国现代医生 62.13(2024):15-20.