Development and validation of a predictive model for patients with post-extubation dysphagia

作     者：Jia-ying Tang Xiu-qin Feng Xiao-xia Huang Yu-ping Zhang Zhi-ting Guo Lan Chen Hao-tian Chen Xiao-xiao Ying Jia-ying Tang;Xiu-qin Feng;Xiao-xia Huang;Yu-ping Zhang;Zhi-ting Guo;Lan Chen;Hao-tian Chen;Xiao-xiao Ying

作者机构：Nursing Departmentthe Second Affiliated Hospital of Zhejiang University School of MedicineHangzhou 310009China 

出 版 物：《World Journal of Emergency Medicine》 (世界急诊医学杂志（英文）)

年 卷 期：2023年第14卷第1期

页      面：49-55页

核心收录：

学科分类：1002[医学-临床医学] 100214[医学-肿瘤学] 10[医学] 

基　　金：supported by the Health Science and Technology Project of Zhejiang Province the Health Science and Technology Project of Zhejiang Province The local institutional review board reviewed and approved the study 

主　　题：Post-extubation dysphagia Nomogram Predictive model 

摘      要：BACKGROUND:Swallowing disorder is a common clinical symptom that can lead to a series of complications,including aspiration,aspiration pneumonia,and *** study aimed to investigate risk factors of post-extubation dysphagia(PED)in intensive care unit(ICU)patients with endotracheal intubation,and to develop a risk-predictive model for PED,which could serve as an assessment tool for the prevention and control of ***:Patients retrospectively selected from June to December 2021 in a tertiary hospital served as the derivation *** recruited from the same hospital from March to June 2022served as the external validation cohort for the predictive *** used a combination of variable screening and least absolute shrinkage and selection operator(LASSO)regression to select the most useful candidate predictors and checked the multicollinearity of independent variables using the variance inflation factor *** logistic regression analysis was performed to calculate the odds ratio(OR;95%confidence interval[95%CI])and P-value for each variable to predict *** screened risk factors were introduced into R software to build a nomogram *** performance of the model,including discrimination ability,calibration,and clinical benefit,was evaluated by plotting the receiver operating characteristic(ROC),calibration,and decision ***:A total of 305 patients were included in this *** them,235 patients(53PED vs.182 non-PED)were enrolled in the derivation cohort,while 70 patients(17 PED vs.53 nonPED)were enrolled in the validation *** independent predictors included age,pause of sedatives,level of consciousness,activities of daily living(ADL)score,nasogastric tube,sore throat,and voice *** predictors were used to establish the predictive nomogram *** model demonstrated good discriminative ability,and the area under the ROC curve(AUC)was 0.945(95%CI 0.904-0.970).Applying the predictive model