基于思维导图联合定量化预测模型对腹泻合并心肌损害患儿的护理实践探索

    Exploration of nursing practice for children with diarrhea complicated with myocardial damage based on mind map combined with quantitative prediction model

    • 摘要:
      目的 探讨基于思维导图联合定量化预测模型对腹泻合并心肌损害患儿的护理实践。
      方法 选取168例腹泻患儿作为研究对象, 采用LASSO回归分析筛选腹泻合并心肌损害的预测因子, 采用logistic回归分析确定腹泻合并心肌损害的独立危险因素, 并建立腹泻合并心肌损害的列线图预测模型和思维导图。
      结果 168例腹泻患儿中, 62例发生心肌损害, 心肌损害的发生率为36.90%(62/168)。logistic回归分析结果显示, 年龄≤1岁、低钾血症、贫血、代谢性酸中毒、中重度脱水、低蛋白血症及感染性腹泻是腹泻合并心肌损害的危险因素(P < 0.05~P < 0.01)。列线图模型结果显示, 模型C-index为0.799(95%CI: 0.763~0.836), 校正曲线与理想曲线有较好的拟合度, AUC为0.782(95%CI: 0.748~0.816), 灵敏度为81.30%, 特异度为74.50%。决策曲线显示, 阈值概率在6%~88%时, 采用该列线图预测腹泻合并心肌损害具有较高的净获益值。建立的思维导图可清晰展示腹泻合并心肌损害的危险指标和危险分层。
      结论 建立的腹泻合并心肌损害的列线图具有较好的预测能力和临床效用, 联合思维导图可帮助医务人员理解和记忆模型的临床意义。

       

      Abstract:
      Objective To explore the nursing practice of children with diarrhea complicated with myocardial damage based on mind map combined with quantitative prediction model.
      Methods A total of 168 children with diarrhea were selected as the study subjects. LASSO regression analysis was used to screen for predictive factors for diarrhea complicated with myocardial damage, logistic regression analysis was used to identify independent risk factors for diarrhea complicated with myocardial damage, and nomogram prediction model and mind map were established for diarrhea complicated with myocardial damage.
      Results Among the 168 children with diarrhea, 62 cases experienced myocardial damage, with an incidence rate of 36.90% (62/168). The results of logistic regression analysis showed that age≤1 year old, hypokalemia, anemia, metabolic acidosis, moderate to severe dehydration, hypoalbuminemia, and infectious diarrhea were risk factors for diarrhea complicated with myocardial damage (P < 0.05 to P < 0.01). The results of the nomogram model indicated that the C-index of the model was 0.799 (95%CI: 0.763-0.836), and the calibration curve had a good fit with the ideal curve.The AUC was 0.782 (95%CI: 0.748-0.816), with a sensitivity of 81.30% and a specificity of 74.50%. The decision curve displayed that when the threshold probability was 6%-88%, there was a higher net benefit value using this nomogram to predict diarrhea complicated with myocardial damage. The established mind map could clearly display the risk indicators and risk stratification of diarrhea complicated with myocardial damage.
      Conclusions The established nomogram of diarrhea complicated with myocardial damage has good predictive ability and clinical utility, which combined mind map can help medical staffs understand and remember the clinical significance of the model.

       

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