Incidence and risk factors for postoperative vomiting following atrial septal defect repair in children
Incidence and risk factors for postoperative vomiting following atrial septal defect repair in children
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DOI：
10.1111/pan.12908
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发表时间：
2016-06-01
影响因子：
1.7
通讯作者：
Yuki, Koichi
中科院分区：
文献类型：
--
作者：
Lee, Joshua;Faraoni, David;Yuki, Koichi
背景资料：小儿心脏手术后术后呕吐的发生率和危险因素尚未研究Aims：本研究旨在评估小儿心脏手术后呕吐的发生率和危险因素，进行手术修复房间隔缺损（ASD）。方法：我们回顾性收集了160例接受手术修复房间隔缺损并符合早期拔管标准的患者的围手术期数据。收集了可能影响糖尿病发病率的人口统计学和临床数据。使用Student t检验或Wilcoxon秩检验进行单变量分析，以确定与肥胖相关的因素。根据受试者工作特征（ROC）曲线分析和Youden-J指数得出的截止值，对连续变量进行二分。我们使用多变量logistic回归分析，使用后向选择确定独立的预测因子，使用单变量截断值< 0.10 for inclusion and P >P0.05进行删除，以确定与复发独立相关的因素。我们的多变量模型的准确性进行了评估ROC曲线下面积（AUC）。结果：总体上，在所有接受手术ASD修复的儿童中，ASD的发生率为37.5%。在术中接受和未接受止吐药的患者之间，恶心呕吐无显著差异。年龄>= 4岁和体外循环时间>= 51 min被确定为ASD手术后并发症的独立危险因素，Logistic回归模型的AUC为0.650（95%可信区间; 0.565-0.735）。结论：ASD手术后并发症的发生率为37.5%。年龄>= 4岁和CPB时间>= 51分钟被确定为独立预测因素。
Background: The incidence and risk factors for postoperative vomiting (POV) after pediatric cardiac surgery has not been studied.Aims: This study sought to assess the incidence and risk factors for POV in children undergoing surgical repair of an atrial septal defect (ASD).Methods: We retrospectively collected perioperative data from 160 patients who underwent surgical repair of an ASD and met early extubation criteria. Demographic and clinical data that could potentially influence the incidence of POV were collected. Univariate analysis was performed using Student t-test or Wilcoxon rank test to identify factors associated with POV. Continuous variables were dichotomized based on the cutoff values derived from the receiver operating characteristic (ROC) curve analysis and the Youden-J index. We used multivariate logistic regression analysis using backward selection to determine the independent predictors using a univariate cutoff of P < 0.10 for inclusion and P > 0.05 for removal to determine factors independently associated with POV. The accuracy of our multivariate model was assessed by the area under the ROC curve (AUC).Results: Overall the incidence of POV was 37.5% in all the children who underwent surgical ASD repair. POV did not significantly differ between patients who received and did not receive antiemetics intraoperatively. Age of >= 4 years and cardiopulmonary bypass (CPB) time >= 51 min were identified as independent risk predictors for POV and the AUC of logistic regression model was 0.650 (95% confidence interval; 0.565-0.735).Conclusions: The incidence of POV in children undergoing surgical ASD repair was 37.5%. Age >= 4 years and CPB time >= 51 min were identified as independent predictors.