Does measurement of preoperative anxiety have added value for predicting postoperative nausea and vomiting?.
Does measurement of preoperative anxiety have added value for predicting postoperative nausea and vomiting?.
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DOI：
10.1213/01.ane.0000149325.20542.d4
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发表时间：
2005-05-01
影响因子：
5.7
通讯作者：
Kalkman, CJ
中科院分区：
文献类型：
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作者：
Van den Bosch, JE;Moons, KG;Kalkman, CJ
术前焦虑被认为是术后恶心呕吐（PONV）的预测因子，但缺乏支持性数据。我们通过多变量logistic回归分析，对1389例接受各种手术的外科住院患者的术前焦虑对POW的预测值进行了量化。研究的预测因素包括PONV或运动病史、吸烟、性别、年龄、种族、体重指数、阿萨身体状况、手术类型、麻醉持续时间、麻醉技术和术后阿片类镇痛。采用Spielberger状态-特质焦虑量表和Amsterdam术前焦虑和信息量表测量焦虑。结果是术后24 h内PONV的发生率。包括性别、年龄、吸烟、PONV或晕动病史、手术类型和麻醉技术在内的多变量（logistic回归）模型的受试者工作特征曲线下面积为0.72（95%置信区间，0.70-0.74）。焦虑与PONV有微弱但显著的相关性，但在模型中加入焦虑并没有进一步增加受试者工作特征曲线下面积。因此，如果已经考虑了其他预测因素，那么常规的术前焦虑测量似乎没有必要。
Preoperative anxiety has been suggested as a predictor of postoperative nausea and vomiting (PONV), but supporting data are lacking. We quantified the added predictive value of preoperative anxiety to established predictors of POW in 1389 surgical inpatients undergoing various procedures, by using multivariate logistic regression analysis. Investigated predictors were a history of PONV or motion sickness, smoking, sex, age, ethnicity, body mass index, ASA physical status, surgery type, duration of anesthesia, anesthetic technique, and postoperative opioid analgesia. Anxiety was measured by the Spielberger State-Trait Anxiety Inventory and the Amsterdam Preoperative Anxiety and Information Scale. The outcome was the occurrence of PONV in the first 24 h after surgery. The area under the receiver operating characteristic curve of a multivariate (logistic regression) model including sex, age, smoking, history of PONV or motion sickness, surgery type, and anesthetic technique was 0.72 (95% confidence interval, 0.70-0.74). There was a weak but significant association of anxiety with PONV, but the addition of anxiety to the model did not further increase the area under the receiver operating characteristic curve. Therefore, routine preoperative measurement of anxiety does not seem warranted, provided that the other predictors are already considered.