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| Construction of a line graph model for predicting the risk of acute respira- tory distress syndrome after valve replacement under extracorporeal circulation |
| CHEN Yongliang1 XUE Jing2 FANG Daguang1 SONG Wei3 CUI Chunyan1 LI Fangliang1 FENG Zengbin1 |
1.Department of Cardiosurgery, the Affiliated Hospital of Chengde Medical University, Hebei Province, Chengde 067000, China;
2.Basic Medical College, Chengde Medical University, Hebei Province, Chengde 067000, China;
3.Department of Gastroenterology, the Second Affiliated Hospital of Xingtai Medical University, Hebei Province, Xingtai 054000, China
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Abstract Objective To investigate the risk factors of acute respiratory distress syndrome after valve replacement under extracorporeal circulation and to construct a columnar graphical model of the risk of its occurrence. Methods Two hundred and eleven patients who underwent valve replacement surgery under extracorporeal circulation at the Affiliated Hospital of Chengde Medical College from November 2016 to December 2020 were selected and divided into 16 cases in the experimental group and 195 cases in the control group based on whether acute respiratory distress syndrome occurred after surgery. Multi-factor logistic regression analysis was used to obtain their independent risk factors; R software was applied to develop column line graph models and validate their predictive efficacy. Results The differences in age, body mass index, cerebral infarction, cardiac function class, replacement of biological valves, time to extracorporeal circulation, time to aortic block, and second open heart were statistically significant when comparing the two groups (P＜0.05). The logistic regression results showed that age (OR[95%CI]=1.266[1.057, 1.517]), body mass index (OR[95%CI]=1.860[1.158, 2.988]), and duration of extracorporeal circulation (OR[95%CI]=1.089[1.025, 1.158]) were independent risk factors for the development of ARDS (P＜0.05). The column line graph model was constructed based on the above independent risk factors, and external validation showed that the consistency index of the model was 0.918 and the area under the curve was 0.922, which had good consistency and predictive efficacy. Conclusion To construct a nomogram of ARDS after valve replacement under CPB, which can realize visualization and individualized prediction, has guiding significance for formulating individualized preventive measures, and has high clinical value.
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