Influencing factors and prediction model construction of spontaneous breathing trial outcome of mechanical ventilation patients

XU Huimei; ZHENG Yanqi

doi:10.12104/j.issn.1674-4748.2023.34.002

Abstract：Objective:To investigate the factors influencing of spontaneous breathing trial(SBT)outcome of mechanical ventilation patients in intensive care unit(ICU),and construct a prediction model to provide reference for the selection of spontaneous breathing trial(SBT)for clinical patients.Methods:This study was a retrospective study.General data of 330 patients in the Department of Intensive Care Medicine of the Second People's Hospital of Lianyungang City from January 1 to December 31,2022 were collected,and they were divided into successful group(n=264)and failure group(n=66)according to the outcome of spontaneous breathing trial.General data of the two groups were compared and analyzed.Variables with statistically significant differences were selected for binary Logistic regression analysis,and a prediction model for the spontaneous breathing trial outcome was established according to the analysis results.Receiver operating characteristic(ROC)curve was drawn to verify the application efficiency of the model,and Hosmer-Lemeshow goodness of fit test was used to evaluate the prediction effect of the model.Results:Unifactor analysis showed that there were statistically significant differences in APACHE Ⅱ score,the number of days of tube insertion,sputum intensity,blood gas pH value before spontaneous breathing trial,albumin,state of consciousness,vasoactive drugs and Nutrition Score(NRS-2002)between the two groups(P＜0.05).Binary Logistic regression analysis showed that the number of days of tube insertion,sputum intensity,Nutritional Score,state of consciousness and vasoactive drugs were the influencing factors of spontaneous breathing trial outcome.According the receiver operating characteristic(ROC)curve was drawn.The area under the curve was 0.926[95％CI(0.896,0.956)],the Jorden index was 0.697,the cutoff value was 0.866,and the sensitivity was 0.879[95％CI(0.779,0.937)].The specificity was 0.818[95％CI(0.767,0.860)],and Hosmer-Lemeshow test showed no statistical significance(x2=6.253,P=0.619).Conclusions:The number of days of tube insertion,sputum intensity,state of consciousness,Nutritional Score and vasoactive drugs were the factors influencing the outcome of the spontaneous breathing trial,which could predict the outcome of spontaneous breathing trial.