Prognostic predictive model for PONV in cesarean delivery

Keywords: Postoperative nausea and vomiting, Cesarean section, Spinal anesthesia, Prognosis, Predictive model, Anesthesiology

Abstract

Introduction: Apfel simplified risk score for postoperative nausea and vomiting   (PONV) has shown to be useful in anesthesia; however, since it has not been calibrated in regional anesthesia or in pregnant patients, its use in cesarean section is limited.  

Objectives: To develop a prognostic predictive model for postoperative nausea and vomiting in pregnant patients undergoing cesarean section under spinal anesthesia.  

Methods: In a cohort of 703 term pregnant patients scheduled of cesarean section, 15 variables were prospectively assessed, to design a prognostic predictive model for the development of postoperative nausea and vomiting. A logistic regression analysis was used to construct the model and its calibration and discrimination were based on the Hosmer-Lemeshow test, the calibration curves, and C statistic. Additionally, the internal calibration was performed with the Bootstrap resampling method.

Results: Postoperative nausea and vomiting were experienced by 27 % of the patients during the first six hours after surgery. The model included as prognostic variables the development of intraoperative nausea and vomiting, age under 28 years, a history of PONV, the mother’s BMI and the weight of the newborn baby. The model showed an adequate calibration (χ2: 4.65 p: 0.5888), though a low discrimination (Statistic C = 0.68).

Conclusions: A prognostic predictive model was created for the development of PONV in cesarean section. This model was used to build a prognostic scale for the classification of patients into risk groups.

References

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How to Cite
1.
De La Peña M, Giraldo OL, Aguirre DC, De La Peña AJ, Arango JJ, Martínez R. Prognostic predictive model for PONV in cesarean delivery. Colomb. J. Anesthesiol. [Internet]. 2023 May 24 [cited 2023 Sep. 27];51(3). Available from: https://www.revcolanest.com.co/index.php/rca/article/view/1077

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Published
2023-05-24
How to Cite
1.
De La Peña M, Giraldo OL, Aguirre DC, De La Peña AJ, Arango JJ, Martínez R. Prognostic predictive model for PONV in cesarean delivery. Colomb. J. Anesthesiol. [Internet]. 2023 May 24 [cited 2023 Sep. 27];51(3). Available from: https://www.revcolanest.com.co/index.php/rca/article/view/1077
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