Journal of multidisciplinary healthcare
Development and Internal Validation of a Perioperative Model for Predicting Early Postoperative Nausea and Vomiting After Gynecologic Laparoscopic Surgery
By Zheng Z, Wu Q and Zhou Y.
Abstract
Background
Postoperative nausea and vomiting (PONV) is a frequent complication after gynecologic laparoscopic surgery. The classic Apfel score is widely used for risk assessment, but its individual-level discrimination may be limited in this relatively homogeneous high-risk population.
Methods
We conducted a single-center prospective observational model-development study of 487 patients undergoing gynecologic laparoscopic surgery under general anesthesia. Nineteen candidate predictors were considered. Exploratory univariable screening (P<0.10), followed by backward elimination using the Akaike information criterion, was used to derive the multivariable logistic model. The blood-loss cut-point was selected by comparing candidate cut-points that retained at least 10% of patients in each group. Internal validation used 1000 bootstrap resamples in which the complete screening, cut-point selection, and backward-elimination procedure was repeated.