| Objective: To explore the risk factors of hypoxemia after Stanford type A aortic dissection (ATAAD) operation , and to construct nomogram prediction model for the occurrence of risks. Methods: 120 ATAAD patients admitted to the Second Affiliated Hospital of Xi''an Jiaotong University from June 2021 to June 2023 were selected, according to whether hypoxemia occurred after operation, patients were divided into occurrence group (n=68) and non-occurrence group (n=52). The clinical data of all subjects were collected, the risk factors affecting postoperative hypoxemia in patients were analyzed, and constructed the prediction model based on these risk factors.The predictive efficacy of prediction model for postoperative hypoxemia in patients was analyzed by receiver operating characteristic (ROC) curve. Results: There were statistical differences in age, body mass index (BMI), leukocyte, alanine aminotransferase (ALT), interleukin-6 (IL-6) and high-sensitivity C-reactive protein (hs-CRP) between occurrence group and non-occurrence group (P<0.05). The independent risk factors for postoperative hypoxemia in ATAAD patients included high BMI,high leukocyte, high ALT, high IL-6, and high hs-CRP (P<0.05). The area under the curve (AUC) of BMI, leukocyte, ALT, IL-6, hs-CRP and nomogram prediction models were 0.800, 0.867, 0.661, 0.639, 0.829 and 0.974 respectively. The model performed well in the internal verification of Bootstrap method (B=1000), Bias-corrected prediction curve basically coincides with the Ideal line, and the C-index was 0.948, showed that the model had good prediction ability. According to the decision curve analysis, the threshold probability range of the model was between 0.01 and 0.97, and its net benefit was higher than the two invalid lines, which showed that the model had a good risk-benefit ratio when predicting the occurrence of hypoxemia. Conclusion: High BMI, leukocyte, ALT, IL-6 and hs-CRP levels are associate with the risk of hypoxemia after ATAAD, the nomogram prediction model based on risk factors can be used to assess the risk of postoperative hypoxemia in patients. |
