Construction of a risk prediction model for unplanned intraoperative hypothermia in patients undergoing off-pump coronary artery bypass grafting
Feng Min
Ma Wenjuan
Jiayinaer Muhataile
Hu Yuan
LI Ru
Xu Yueshu
Li Li
Abstract：Objective To analysis of the risk factors for intraoperative inadvertent hypothermia(IIH)in patients undergoing off-pump coronary artery bypass(OPCAB),and develop and validate a predictive model.Methods The clinical data of 157 OPCAB patients from January 2023 to January 2024 were analyzed.Patients were divided into the hypothermia group(n=82)and the non-hypothermia group(n=75)based on intraoperative temperature.Univariate analysis and LASSO regression were used to screen predictive factors,and a risk prediction model was developed using logistic regression,followed by nomogram construction.The model's discrimination,calibration,and clinical utility were evaluated using the area under the receiver operating characteristic curve(ROC-AUC),Hosmer-Lemeshow(H-L)goodness-of-fit test,and decision curve analysis(DCA),respectively.Internal validation was performed using the bootstrap method.Results The incidence of IIH in OPCAB patients was 52.23%.Four factors-admission temperature≥36.35℃,BMI≥25.93(kg/m2),intraoperative fluid infusion≥2025 ml,and intraoperative blood loss>300 ml-were included in the model.The model achieved an ROC-AUC of 0.821(95%CI:0.756-0.886),with good calibration shown by the H-L test,and DCA indicated favorable clinical utility.Internal validation an ROC-AUC of 0.801(95%CI:0.731-0.871)and Brier scores of 0.151 and 0.212 for the development and validation datasets,respectively.Conclusion The incidence of IIH in OPCAB patients is high.The nomogram model established in this study demonstrates good predictive performance and can serve as a reference for early assessment and prevention by medical staff.
Keywords：Off-pump coronary artery bypass graftingIntraoperative hypothermiaNomogramRisk factorPredictive model
Publication Date：2025-02-27
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：6( 11-16 )