Abstract：
OBJECTIVE: Postoperative sore throat (POST) is a major complaint after day-case surgery. The objectives of this study were to investigate the risk factors for POST and develop a stratified nursing model for POST after day-case surgery.
METHODS: This case-control study was conducted at Department of Anesthesiology of 1st Affiliated Hospital of Wenzhou Medical University in Wenzhou, Zhejiang, China.
METHODS: Anesthesia records and postanesthesia care files of adult patients undergoing day-case surgery with general anesthesia were reviewed. The primary outcome was the incidence of POST at 24 hours after day-case surgery or before discharge within 24 hours. Multivariate logistics regression was used to identify risk factors for POST. A nomogram was created to predict the probability of POST after day-case surgery.
RESULTS: A total of 9,312 records were retrieved from June 1, 2021 to April 30, 2022, including 8,499 files in the training group and 813 files in the validation group. One thousand five hundred and twenty-five cases in the training group experienced POST. The independent risk factors for POST included: thyroid surgery (odds ratios [OR] = 22.42, 95% confidence intervals [CI]: 18.45 to 27.25), shorter thyromental distance (OR = 1.18, 95% CI: 1.06 to 1.30), smaller neck circumference (OR = 1.09, 95% CI: 1.06 to 1.11), duration of anesthesia (OR = 1.13, 95% CI: 1.04 to 1.22), female (OR = 1.66, 95% CI: 1.41 to 1.96), age (OR = 0.99, 95% CI: 0.99 to 1.00) and the presence of bloody sputum (OR = 8.33, 95% CI: 6.53 to 10.63). A nomogram that involved five factors was established to predict the probability of POST after day-case surgery. The area under the receiver operating characteristic curve in the training and validation groups was 0.77 and 0.81, respectively. The calibration curve demonstrated good consistency between the actual POST and the predicted probability.
CONCLUSIONS: The following variables are independently associated with POST: thyroid surgery, age approaching to 40 years old, female, shorter thyromental distance and smaller neck circumference, longer duration of anesthesia, and the presence of bloody sputum. A novel stratified nursing model is feasible for predicting the probability of POST.
METHODS: This case-control study was conducted at Department of Anesthesiology of 1st Affiliated Hospital of Wenzhou Medical University in Wenzhou, Zhejiang, China.
METHODS: Anesthesia records and postanesthesia care files of adult patients undergoing day-case surgery with general anesthesia were reviewed. The primary outcome was the incidence of POST at 24 hours after day-case surgery or before discharge within 24 hours. Multivariate logistics regression was used to identify risk factors for POST. A nomogram was created to predict the probability of POST after day-case surgery.
RESULTS: A total of 9,312 records were retrieved from June 1, 2021 to April 30, 2022, including 8,499 files in the training group and 813 files in the validation group. One thousand five hundred and twenty-five cases in the training group experienced POST. The independent risk factors for POST included: thyroid surgery (odds ratios [OR] = 22.42, 95% confidence intervals [CI]: 18.45 to 27.25), shorter thyromental distance (OR = 1.18, 95% CI: 1.06 to 1.30), smaller neck circumference (OR = 1.09, 95% CI: 1.06 to 1.11), duration of anesthesia (OR = 1.13, 95% CI: 1.04 to 1.22), female (OR = 1.66, 95% CI: 1.41 to 1.96), age (OR = 0.99, 95% CI: 0.99 to 1.00) and the presence of bloody sputum (OR = 8.33, 95% CI: 6.53 to 10.63). A nomogram that involved five factors was established to predict the probability of POST after day-case surgery. The area under the receiver operating characteristic curve in the training and validation groups was 0.77 and 0.81, respectively. The calibration curve demonstrated good consistency between the actual POST and the predicted probability.
CONCLUSIONS: The following variables are independently associated with POST: thyroid surgery, age approaching to 40 years old, female, shorter thyromental distance and smaller neck circumference, longer duration of anesthesia, and the presence of bloody sputum. A novel stratified nursing model is feasible for predicting the probability of POST.
摘要：
目的：术后咽喉痛（POST）是日常手术后的主要主诉。本研究的目的是调查POST的危险因素，并建立日间手术后POST的分层护理模式。
方法：本病例对照研究在温州医科大学附属第一医院麻醉科进行,浙江,中国。
方法：回顾成年患者全麻日间手术的麻醉记录和麻醉后护理档案。主要结果是日间手术后24小时或出院前24小时内POST的发生率。多因素物流回归用于识别POST的危险因素。创建列线图以预测日间手术后POST的概率。
结果：从2021年6月1日至2022年4月30日，共检索了9,312条记录，其中包括训练组的8,499个文件和验证组的813个文件。训练组中的一千五百二十五例经历了POST。术后的独立危险因素包括：甲状腺手术（比值比[OR]=22.42，95％置信区间[CI]：18.45至27.25），甲状腺距离较短（OR=1.18，95%CI：1.06至1.30），颈围较小(OR=1.09，95%CI：1.06至1.11)，麻醉持续时间（OR=1.13，95%CI：1.04至1.22），女性（OR=1.66，95%CI：1.41至1.96），年龄（OR=0.99，95％CI：0.99至1.00）和血痰的存在（OR=8.33，95％CI：6.53至10.63）。建立了涉及五个因素的列线图，以预测日间手术后POST的可能性。训练组和验证组的受试者工作特征曲线下面积分别为0.77和0.81。校准曲线证明了实际POST和预测概率之间的良好一致性。
结论：以下变量与术后独立相关：甲状腺手术，年龄接近40岁，女性,更短的甲状腺距离和更小的颈围，麻醉持续时间较长，还有血痰的存在.一种新的分层护理模式对于预测POST的概率是可行的。
方法：本病例对照研究在温州医科大学附属第一医院麻醉科进行,浙江,中国。
方法：回顾成年患者全麻日间手术的麻醉记录和麻醉后护理档案。主要结果是日间手术后24小时或出院前24小时内POST的发生率。多因素物流回归用于识别POST的危险因素。创建列线图以预测日间手术后POST的概率。
结果：从2021年6月1日至2022年4月30日，共检索了9,312条记录，其中包括训练组的8,499个文件和验证组的813个文件。训练组中的一千五百二十五例经历了POST。术后的独立危险因素包括：甲状腺手术（比值比[OR]=22.42，95％置信区间[CI]：18.45至27.25），甲状腺距离较短（OR=1.18，95%CI：1.06至1.30），颈围较小(OR=1.09，95%CI：1.06至1.11)，麻醉持续时间（OR=1.13，95%CI：1.04至1.22），女性（OR=1.66，95%CI：1.41至1.96），年龄（OR=0.99，95％CI：0.99至1.00）和血痰的存在（OR=8.33，95％CI：6.53至10.63）。建立了涉及五个因素的列线图，以预测日间手术后POST的可能性。训练组和验证组的受试者工作特征曲线下面积分别为0.77和0.81。校准曲线证明了实际POST和预测概率之间的良好一致性。
结论：以下变量与术后独立相关：甲状腺手术，年龄接近40岁，女性,更短的甲状腺距离和更小的颈围，麻醉持续时间较长，还有血痰的存在.一种新的分层护理模式对于预测POST的概率是可行的。
