Application of a nomogram risk prediction model for emergence agitation in pediatric patients undergoing general anesthesia

LIANG Yumei; HE Ruofei; TAO Pinyue; LU Shuyu; LIANG Yi; ZENG Fei

doi:10.3969/j.issn.2096-2681.2025.06.005

Abstract：Objective To explore the application effect of a nomogram risk prediction model for emergence agitation(EA)in pediatric patients undergoing general anesthesia.Methods Using convenience sampling,486 pediatric patients who entered the post anesthesia care unit(PACU)after general anesthesia from January 2021 to June 2022 in the Second Affiliated Hospital of Guangxi Medical University were classified into the internal validation group,and 189 pediatric patients who entered the PACU from July 2022 to December 2022 were classified into the external validation group.The clinical characteristics of the internal and external validation groups were compared.The application effect of the model was tested using the area under the curve(AUC)of the receiver operating characteristic(ROC curve),and external validation was performed using the validation group data.Results There were no statistically significant differences in the clinical characteristics between the internal and external validation groups(all P＞0.05).AUC was 0.827(95%CI:0.777-0.900).At a risk probability threshold of 0.119,the Youden index reaches its maximum value of 0.588,with a sensitivity of 86.7%and a specificity of 72.1%.The Hosmer-Lemeshow test yielded χ2=5.925,P=0.656,and the external validation C-index was 0.827.Conclusion The model demonstrates good application performance and is suitable for clinical use.It can predict the risk of EA at the time of PACU admission,providing a reference for healthcare providers to implement preventive interventions and nursing strategies for high-risk pediatric patients postoperatively.