Construction and validation of a risk prediction model for emergence agitation in children with obstructive sleep apnea syndrome

doi:10.19438/j.cjoms.2024.02.011

Abstract

Abstract: PURPOSE: To construct and validate the risk prediction model of emergence agitation (EA) after surgery in children with obstructive sleep apnea syndrome(OSAS). METHODS: A total of 665 children aged 3-12 years who received OSAS surgery under general anesthesia were selected as the study subjects and randomly divided into modeling group (n=499) and verification group (n=166). According to the occurrence of emergence agitation, the patients were divided into EA group and non-EA group. Logistic regression analysis was used to screen the risk factors of EA after OSAS in children, so as to establish a risk prediction nomogram model. The prediction efficiency of the model was verified by the area under C-index, calibration curve and receiver operating characteristic curve (ROC), and the risk model was internally verified. SPSS 26.0 software package and R software (V4.1.2) were used for data analysis. RESULTS: The incidence of emergence agitation after OSAS operation was 38.68%. Logistic regression analysis showed that age(OR: 0.494, 95%CI: 0.313-0.778), extubation time(OR: 0.971, 95%CI: 0.953-0.990) and postoperative pain (OR: 1.530, 95%CI: 1.378-1.699) were independent risk factors for emergence agitation after OSAS operation in children (P<0.05). Based on these findings, a risk prediction model was established, and the area under ROC curve was 0.782(95%CI: 0.741-0.823), the sensitivity was 0.599, the specificity was 0.837. The area under ROC curve of the verification group was 0.773 (95%CI: 0.697-0.849), the sensitivity was 0.676, and the specificity was 0.814. CONCLUSIONS: Age, extubation time and postoperative pain are independent risk factors for the occurrence of emergence agitation in children with OSAS operation, and the nomogram model constructed by this method has a good predictive effect on emergence agitation in children with OSAS operation.

Key words: Children, General anesthesia, Obstructive sleep apnea syndrome, Emergence agitation

CLC Number:

R782.05

WANG Jia-hui, DUAN Xiao-wen, ZHOU Xu-hui, QIU Lin, LI Jing-jie, CAI Mei-hua, ZHENG Yong-chao. Construction and validation of a risk prediction model for emergence agitation in children with obstructive sleep apnea syndrome[J]. China Journal of Oral and Maxillofacial Surgery, 2024, 22(2): 175-180.

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