硬膜外分娩镇痛产妇产间发热风险预测模型的构建与验证
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Construction and validation of a predictive model for postpartum fever risk in women undergoing epidural⁃related maternal fever
Abstract Objective：To construct a risk prediction model of epidural⁃related maternal fever（ERMF） and verify the effect.Methods：A prospective study was conducted in a Grade-A obstetrics and gynecology hospital in Jiangsu Province.A total of 780 parturients who received epidural analgesia in the delivery room from January 2022 to July 2022 were selected as subjects.According to diagnosis，they were divided into ERMF group（n=148） and non⁃ERMF group（n=632）.The independent risk factors of ERMF were determined by Logistic regression analysis，and the prediction formula was obtained to construct the risk prediction model.Receiver operating characteristic（ROC） and Hosmer⁃Lemeshow test were used to evaluate the prediction efficiency and goodness of fit of the model.A total of 170 parturients hospitalized from August 2022 to October 2022 were selected as the validation group of the model to verify the prediction model.Results The incidence of ERMF was 19.0% in the modeling group and 20.6% in the validation group.Number of examinations of the vaginal tract，oxytocin use，labor，the time from rupture of membranes to the end of labor，ropivacaine dosage，sufentanil dosage was an independent risk factor of ERMF.The ROC curve of the prediction model was 0.987，the sensitivity was 0.912，the specificity was 0.796，and the Youden index was 0.888.The ROC curve of the verification group was 0.893，the sensitivity was 0.886，the specificity was 0.785.Conclusion：By verifying that the prediction model has good differentiation and calibration degree，it has certain prediction value for identifying high⁃risk ERMF parities，and can provide reference for clinical nursing work，so as to formulate corresponding nursing measures to reduce the risk of ERMF.
Keywords epidural anesthesia； labor analgesia； maternal fever； prediction model； nursing
摘要 目的：构建硬膜外分娩镇痛产妇产间发热（ERMF）风险预测模型并验证效果。（剩余11657字）
