A prediction model for severe early postoperative hypoxemia after Off-pump coronary artery graft

doi:10.3969/j.issn.1672-5301.2017.03.010

Abstract：Objective To study the risk factors of severe early postoperative hypoxemia after off-pump coronary artery graft,and establish a prediction model. Methods Data of 420 consecutive patients from June 2010 to June 2015,who underwent off-pump coronary artery graft in the department of cardiothoracic surgery of Xinhua Hospital,were retrospectively analyzed. All the cases were divided into two groups according to the appear-ance of severe postoperative hypoxemia. All the data about potential risk factors was put into the database and ana-lyzed by logistic regression. The prediction model was then established upon acquired independent risk factors. Dis-crimination and calibration of the prediction model were assessed with ROC curve and Hosmer and Lemeshow goodness of fit test. Results 46 postoperative hypoxemia happened in 69 cases within 48 hours after procedures, with an incidence rate of 10.95%. The logistic regression demonstrated that age,BMI,preoperative ejection fac-tion,preoperative serum myoglobin,emergent off-pump coronary artery graft,and re-exploration within 48 hours after procedures were the independent risk factors for severe postoperative hypoxemia. The prediction model was then established based on these independent risk factors. The area under ROC curve of the model was 0.771,and the P value in Hosmer and Lemeshow goodness of fit test was 0.725. Conclusion The logsitic model built in this study succeeded to predict the incidence of severe postoperative hypoxemia after off-pump coronary artery graft, and it could meet the doctors′ requirement with its excellent discrimination and calibration.