The Sn-modified MnCeLa catalysts show significantly higher resistance to chlorine poisoning than MnCeLa catalysts at different temperatures.
Background: Delirium often occurs in children with congenital heart disease in the early postoperative period, which is not conducive to the rehabilitation and prognosis. There is little evidence to prove the effectiveness and safety of drug treatment of delirium in children, and the prevention has become an important topic. The purpose of this study is to analyze the early risk factors of delirium in children after congenital heart surgery, establish a nomogram prediction model, and explore the application efficiency of the model, so as to provide reference for early prevention of delirium. Methods: A total of 362 children treated in the cardiac intensive care unit (CICU) of Shanghai Children's Medical Center after congenital heart surgery from February 15 to April 15, 2021 were enrolled for the construction of the model. Bedside nurses who received unified training used the Cornell Assessment of Pediatric Delirium (CAPD) to evaluate delirium and recorded sixteen preoperative-and intraoperativerelated influencing factors. A nomogram prediction model was created using multivariate logistic regression. The prediction effect of the model was evaluated by C-index and Brier value, and 96 children from April 16 to May 15, 2021 were included for effect verification. The model's effectiveness was validated by comparing the occurrence of delirium in children predicted by the model with the actual occurrence.Results: Multivariate logistic regression analysis showed that male gender [odds ratio (OR) =1.786, 95% confidence interval (CI): 1.018-3.134, P=0.043], age <6.5 months (OR =0.224, 95% CI: 0.126-0.399, P=0.000), disease severity ≥4 points (OR =6.955, 95% CI: 3.564-13.576, P=0.003), and operation time ≥148 min (OR =2.401, 95%CI: 1.336-4.315, P=0.000) were independent risk factors for delirium in children after cardiac surgery. The C-index of the nomogram prediction model was 0.808, sensitivity was 76.1%, specificity was 70%, and the Brier value was 0.142. The validation of the model showed that the model predicted 20 cases and the actual occurrence was 20 cases, of which 8 cases were false negative and 8 cases were false positive, and the sensitivity, specificity, and accuracy of the model were 60%, 89.5%, and 83.3%, respectively.Conclusions: The prediction model constructed in this study could provide early prediction of the occurrence of delirium in children after congenital heart surgery to a certain extent.
Objective Delirium is a common postoperative complication in children with congenital heart disease, which affects their postoperative recovery. The purpose of this study is to explore the risk factors of delirium and construct nomogram model to provide reference for the prevention and management of postoperative delirium in children with congenital heart disease. Methods 470 children after congenital heart surgery treated in the cardiac intensive care unit(CICU) of Shanghai Children's Medical Center were divided into model group and verification group according to the principle of 7:3 distribution, the delirium related influencing factors of 330 children in the model group were analyzed, the nomogram model was established by lasso regression and logistic regression; The data of 140 children in the validation group were used to verify the effect of the model. esults Multivariate logistic regression analysis showed that age, disease severity, noninvasive ventilation after tracheal intubation extraction, delayed chest closure, phenobarbital dosage, promethazine dosage, mannitol and high fever were independent risk factors for postoperative delirium; The area under the receiver operating characteristic curve(AUC) of the nomogram model was 0.864 and the Brier value was 0.121; Validation of model effect: The results showed that 51 cases were predicted by the model and 34 cases were actually occurred, including 4 cases of false negative and 21 cases of false positive. The positive predictive value was 58.8%, the negative predictive value was 95.5%. Conclusions The nomogram model constructed in this study showed acceptable performance of predicting postoperative delirium in children with congenital heart disease.
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