Multivariate Logistic Regression Analysis Of The Syndrome Of Postoperative Nausea And Vomiting After Thyroidectomy

Objective To investigate the main risk factors related with the syndrome of postoperative nausea and vomiting after thyroidectomy,and to establish Logistic regression equation for impoving their prognosis and quality of life.Methods During the period of October 2007 to October 2008,113 patients underwent thyroidectomy were analyzed retrospectively and Logistic regression analysis was used to detect the risk factors of the syndrome of postoperative nausea and vomiting after the operation.Risk factors included gender,body mass index(BMI),age,type of anaesthesia(general or cervical plexus block anaesthesia),duration of operation,the changes of hemodynamics of the bilateral vertebral artery,smoking history,a history of PONV,ASA physical status.A logistic model was developed to evaluate predictors of this syndrome after thyroidectomy.Result Multivariate Logistic regression analysis was used among the examined factors and the result showed that factors related with the syndrome of postoperative nausea and vominting after thyroidectomy were gender,anesthesia,smoking history, duration of the operation and the changes of hemodynamics of the bilateral vertebral artery.The OR were as the follows by the size of the numerus:the gender of patients (OR=6.321,95%CI:1.609～24.826),smoking history(OR=6.321,95%CI:1.609～24.826),anesthesia(0R=5.296,95%CI:1.069～26.233),the changes of hemodynamics of the right vertebral artery(OR=3.989,95%CI:1.997～7.965),the changes of hemodynamics of the left vertebral artery(OR=3.478,95%CI:1.867～6.480) and duration of the operation(OR=2.831,95%CI:1.134～7.065)。The syndrome of postoperative nausea and vomiting after thyroidectomy was associated with the gender of patients,different means of anesthesia,smoking history,duration of the operation,the changes of hemodynamics of the bilateral vertebral artery.The Logistic regression model was P=1/(1+e^{(14.555-1.844X1-1.667X2-1.844X3-1.040X4-1.383X5-1.247X6)}) that the accuracy,sensitivity and specificity of the Logistic model were 80.0%,88.9%and 85.7%respectively.Conclusion The gender of patients,different means of anesthesia,smoking history,duration of the operation and the changes of hemodynamics of the bilateral vertebral artery are the independent risk factors associated with the syndrome of postoperative nausea and vomiting after thyroidectomy.