Risk factors of intraoperative hypothermia in patients undergoing radical thyroidectomy under laparoscopy and the construction of nomogram model

WANG Huili; LI Huijuan; LU Yan; QIN Xiuyu; CHEN Dandan; XU Yun

doi:10.7619/jcmp.20232740

Journal of Clinical Medicine in Practice > 2024 > 28(4): 29-33. > DOI: 10.7619/jcmp.20232740

WANG Huili, LI Huijuan, LU Yan, QIN Xiuyu, CHEN Dandan, XU Yun. Risk factors of intraoperative hypothermia in patients undergoing radical thyroidectomy under laparoscopy and the construction of nomogram model[J]. Journal of Clinical Medicine in Practice, 2024, 28(4): 29-33. DOI: 10.7619/jcmp.20232740

Citation:

PDF (1164 KB)

Risk factors of intraoperative hypothermia in patients undergoing radical thyroidectomy under laparoscopy and the construction of nomogram model

1.
Operating Room, Huai'an Hospital of Traditional Chinese Medicine, Huai'an, Jiangsu, 223001
2.
Operating Room, the First People's Hospital of Huaian City of Jiangsu Province, Huai'an, Jiangsu, 223399

More Information

Received Date: August 29, 2023
Revised Date: December 25, 2023
Available Online: March 05, 2024

Graphical Abstract

Abstract

Abstract

Objective
To analyze the risk factors of intraoperative hypothermia in patients undergoing radical thyroidectomy under laparoscopy and to construct a nomogram prediction model.
Methods
A total of 336 patients who underwent laparoscopic radical thyroidectomy were selected as study subjects. According to intraoperative body temperature, they were divided into hypothermia group (195 cases) and normal temperature group (141 cases). The risk factors of intraoperative hypothermia in patients undergoing laparoscopic radical thyroidectomy were analyzed using the Logistic regression model. The nomogram prediction model was constructed using R software. The prediction performance of the nomogram prediction model was evaluated using the receiver operating characteristic (ROC) curve, calibration curve, and Hosmer-Lemeshow goodness-of-fit test.
Results
There were significant differences in age, intraoperative blood loss, amount of fluid infusion, and operation time between the two groups (P < 0.05). Multivariate Logistic regression analysis showed that age>60 years, intraoperative blood loss >60 mL, amount of fluid infusion>1 000 mL, and operation time>2.5 h were risk factors for intraoperative hypothermia in patients undergoing laparoscopic radical thyroidectomy (P < 0.05). A nomogram prediction model was constructed based on the four risk factors. The ROC curve showed that the area under the curve was 0.912 (95%CI, 0.884 to 0.941). The calibration curve and Hosmer-Lemeshow goodness-of-fit test showed that the slope of the calibration curve was close to 1 (χ²=9.140, P=0.243).
Conclusion
The nomogram prediction model based on age, intraoperative blood loss, amount of fluid infusion, and operation time has good predictive value for intraoperative hypothermia in patients undergoing laparoscopic radical thyroidectomy.
- laparoscopic radical thyroidectomy,
- hypothermia,
- risk factors,
- nomogram model,
- hemorrhage

FullText(HTML)

References (23)

References

[1]	李英杰, 王芳, 卢想. 麻醉诱导前给予咪达唑仑对甲状腺癌根治术患者E、NE及IL-10水平的影响[J]. 解放军医药杂志, 2022, 34(2): 44-47. https://www.cnki.com.cn/Article/CJFDTOTAL-HBGF202202010.htm
[2]	汲权威. 完全腔镜下甲状腺癌根治术对患者机体应激反应、预后的影响分析[J]. 四川解剖学杂志, 2020, 28(1): 61-62, 74. https://www.cnki.com.cn/Article/CJFDTOTAL-SCGP202001029.htm
[3]	杜德良, 王红. 全腔镜甲状腺癌根治术与传统开放手术的临床效果分析[J]. 腹腔镜外科杂志, 2022, 27(6): 406-409. https://www.cnki.com.cn/Article/CJFDTOTAL-FQJW202206002.htm
[4]	ZOU B W, TU Y, LIAO D W, et al. Radical esophagectomy for stage Ⅱ and Ⅲ thoracic esophageal squamous cell carcinoma followed by adjuvant radiotherapy with or without chemotherapy: which is more beneficial[J]. Thorac Cancer, 2020, 11(3): 631-639. doi: 10.1111/1759-7714.13307
[5]	史卓颖, 张海伟, 杜祥飞. 全身麻醉病人术中低体温发生预测模型的建立[J]. 护理研究, 2021, 35(2): 246-249. https://www.cnki.com.cn/Article/CJFDTOTAL-SXHZ202102010.htm
[6]	王杰, 马雪松, 樊桂波, 等. 围术期体温监测及保温的现状分析[J]. 现代生物医学进展, 2019, 19(3): 583-586. https://www.cnki.com.cn/Article/CJFDTOTAL-SWCX201903045.htm
[7]	DENDIS M, HOOVEN K. Preventing hypothermia during cesarean birth: an integrative review[J]. MCN Am J Matern Child Nurs, 2020, 45(2): 102-108. doi: 10.1097/NMC.0000000000000599
[8]	海洁, 白立炜, 王艾蒙. 围手术期多学科协作对甲状腺癌根治术患者术后恢复、负性情绪的影响[J]. 癌症进展, 2022, 20(2): 196-199. https://www.cnki.com.cn/Article/CJFDTOTAL-AZJZ202202026.htm
[9]	费阳, 李阳, 陈峰, 等. 完全腔镜甲状腺癌根治术对患者创伤应激与免疫的影响[J]. 腹腔镜外科杂志, 2022, 27(7): 483-486. https://www.cnki.com.cn/Article/CJFDTOTAL-FQJW202207002.htm
[10]	岳璇弟, 刘文亚, 向玲, 等. 全腔镜甲状腺切除术治疗分化型甲状腺癌的效果及复发危险因素分析[J]. 解放军医药杂志, 2021, 33(6): 30-34. https://www.cnki.com.cn/Article/CJFDTOTAL-HBGF202106007.htm
[11]	白海燕, 周建玲, 张莹, 等. 儿童术中低体温对凝血功能、炎症反应和术后感染发生的影响及术中低体温危险因素分析[J]. 临床和实验医学杂志, 2022, 21(24): 2650-2654. https://www.cnki.com.cn/Article/CJFDTOTAL-SYLC202224020.htm
[12]	鲍加玉, 李海龙, 温儒民. 术中低温对肌层浸润性膀胱癌行腹腔镜膀胱根治性切除术后并发症及预后的影响[J]. 中国临床医生杂志, 2021, 49(1): 82-84. https://www.cnki.com.cn/Article/CJFDTOTAL-ZLYS202101026.htm
[13]	GUNDERSEN S K, MEYHOFF C S, WETTERSLEV J, et al. The impact of intraoperative fluid therapy and body temperature on surgical site infection-reassessment of a randomized trial[J]. Chirurgia, 2018, 113(4): 516-523. doi: 10.21614/chirurgia.113.4.516
[14]	GALA T, SHAHZAD N, EDHI A I, et al. Perioperative hypothermia in colorectal surgeries: are we doing enough to prevent it[J]. J Pak Med Assoc, 2020, 70(2): 304-307.
[15]	宁红岩, 王颖, 陈辰, 等. 加热措施对腹腔镜手术患者影响的研究[J]. 中国实用护理杂志, 2019, 35(33): 2584-2587. https://www.cnki.com.cn/Article/CJFDTOTAL-JHSY202312014.htm
[16]	林文慧, 张秀贤, 黄爱虹. 围术期一体化保温护理模式对妇科腔镜手术患者的影响[J]. 齐鲁护理杂志, 2021, 27(16): 139-142. https://www.cnki.com.cn/Article/CJFDTOTAL-QLHL202116059.htm
[17]	袁培培, 魏晓宇, 王宁. 保温护理对妇科腹腔镜手术患者术后低体温与寒战的预防效果[J]. 护理实践与研究, 2020, 17(21): 122-123. https://www.cnki.com.cn/Article/CJFDTOTAL-HLSJ202021049.htm
[18]	成紫琳, 马靓. 开颅手术继发术中低体温的风险模型构建及复合保温措施干预研究[J]. 医学综述, 2021, 27(20): 4150-4155. https://www.cnki.com.cn/Article/CJFDTOTAL-YXZS202120033.htm
[19]	孙亮, 高倩, 王广, 等. 麻醉后恢复室期间全身麻醉患者发生低体温的影响因素[J]. 中华医学杂志, 2021, 101(1): 52-56.
[20]	OKADA N, FUJITA T, KANAMORI J, et al. Efficacy of prewarming prophylaxis method for intraoperative hypothermia during thoracoscopic esophagectomy[J]. Esophagus, 2020, 17(4): 385-391. doi: 10.1007/s10388-020-00743-8
[21]	魏勇, 代德珍, 王辉. 无缝衔接整体干预对重症胰腺炎腹腔镜手术患者术中低体温及预后的影响[J]. 实用医院临床杂志, 2021, 18(4): 185-188. https://www.cnki.com.cn/Article/CJFDTOTAL-YYLC202104054.htm
[22]	LI Y N, LIANG H S, FENG Y. Prevalence and multivariable factors associated with inadvertent intraoperative hypothermia in video-assisted thoracoscopic surgery: a single-center retrospective study[J]. BMC Anesthesiol, 2020, 20(1): 25. doi: 10.1186/s12871-020-0953-x
[23]	李丽, 颜艳, 房馨, 等. 腹腔镜手术患者术中低体温风险预测模型的构建及验证[J]. 中华护理杂志, 2022, 57(4): 463-468. https://www.cnki.com.cn/Article/CJFDTOTAL-ZHHL202204012.htm

Cited By

Get Citation

PDF

XML

Article views (121) PDF downloads (11)

Turn off MathJax

Article Contents

Abstract

References

Risk factors of intraoperative hypothermia in patients undergoing radical thyroidectomy under laparoscopy and the construction of nomogram model

Abstract

References

Catalog

Export File

Citation

Format

Content