婴幼儿法洛四联症完全矫治术后重症监护室 滞留的危险因素及列线图模型构建.

Objective To investigate the risk factors for prolonged intensive care unit (ICU) stay after complete correction of tetralogy of Fallot (TOF) in infants and young children and to construct a nomogram that predicts the risk of postoperative ICU stay. Methods A retrospective analysis was conducted on 157 children with TOF who underwent complete correction surgery at the Fuwai Central Cardiovascular Hospital Children's Heart Center from January 2021 to March 2024. The patients were divided into two groups based on whether they experienced prolonged ICU stay postoperatively: the prolonged stay group (n=40) and the non-prolonged stay group (n=117). Clinical data of the patients were collected, and the least absolute shrinkage and selection operator (LASSO) regression, univariate, and multivariate logistic regression analysis were performed to identify independent predictors of prolonged ICU stay. A nomogram was then constructed based on these predictors, and its predictive value was evaluated using the receiver operating characteristic (ROC) curve. Results Multivariate logistic regression analysis showed that preoperative low body weight (OR=0.607,95% CI:0.391~0.890, P=0.015), high neutrophil-lymphocyte ratio (NLR) (OR=2.499,95% CI:1.483~4.680, P<0.001), longer cardiopulmonary bypass time during surgery (OR=1.037,95% CI: 1.006~1.078, P=0.034), longer duration of postoperative mechanical ventilation (OR=1.094,95% CI: 1.057~1. 149, P<0.001), and occurrence of complications (OR = 14.632,95% CI: 3.074~94.866, P=0.002) were independent predictors of prolonged ICU stay. In internal validation, the ROC curve showed that the nomogram had a good predictive performance for the risk of prolonged ICU stay after complete correction of TOF in infants and young children, with an area under the curve of 0. 981 (95% CI: 0. 965~0.998). Conclusions The nomogram based on body weight, preoperative NLR, cardiopulmonary bypass time, postoperative mechanical ventilation duration, and occurrence of complications has a high predictive value for the risk of prolonged ICU stay after complete correction of TOF in infants and young children. [ABSTRACT FROM AUTHOR]