Academic Journal
Προβολή σε EDS

Construction and validation of a risk prediction model for postoperative nausea and vomiting in craniotomy patients: A cohort study.

Λεπτομέρειες βιβλιογραφικής εγγραφής
Τίτλος: Construction and validation of a risk prediction model for postoperative nausea and vomiting in craniotomy patients: A cohort study.
Συγγραφείς: Wu L; Nursing Department, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, China., Pan H, Xu Y, Ding S
Πηγή: Medicine [Medicine (Baltimore)] 2026 Aug 21; Vol. 105 (34), pp. e50193.
Τύπος έκδοσης: Journal Article; Validation Study
Γλώσσα: English
Στοιχεία περιοδικού: Publisher: Lippincott Williams & Wilkins Country of Publication: United States NLM ID: 2985248R Publication Model: Print Cited Medium: Internet ISSN: 1536-5964 (Electronic) Linking ISSN: 00257974 NLM ISO Abbreviation: Medicine (Baltimore) Subsets: MEDLINE
Imprint Name(s): Original Publication: Hagerstown, Md : Lippincott Williams & Wilkins
Ιατρικοί όροι (MeSH): Craniotomy*/adverse effects , Postoperative Nausea and Vomiting*/epidemiology , Postoperative Nausea and Vomiting*/etiology, Risk Assessment/methods ; Humans ; Female ; Middle Aged ; Male ; Adult ; Retrospective Studies ; Risk Factors ; ROC Curve ; Cohort Studies ; Incidence ; Prediction Algorithms ; Aged
Περίληψη: Postoperative nausea and vomiting (PONV) is one of the most distressing symptoms experienced by patients. The incidence is high, and complications are dangerous. Therefore, it is important to construct a prediction model to enhance the risk assessment strategies. This study included developmental and validation cohorts. The development cohort consisted of patients who underwent craniotomy between January 1, 2021, and December 31, 2022. Data were retrospectively collected to identify the factors associated with PONV events and to construct a risk prediction model. The validation cohort comprised patients from September 1, 2023, to December 22, 2023, at the same hospital. We collected data prospectively, compared the forecasted outcomes with the actual outcomes, and assessed the external validation performance of the model using model evaluation metrics, such as the area under the receiver operating characteristic curve (AUROC), Brier score, and calibration curves. The incidence of PONV within 24 hours after surgery was 27.2% (181 patients). The independent predictors of PONV after craniotomy were sex, age, preoperative sodium level, surgical site, and postoperative intracranial air accumulation. The predictive model had an AUROC of 0.862 (95% confidence interval = 0.829-0.894, P < .001), a sensitivity of 73.5%, a specificity of 86.8%, and an accuracy of 83.2%. External validation revealed an AUROC of 0.832 (95% confidence interval = 0.744-0.920), a sensitivity of 73.2%, a specificity of 90.3%, and an accuracy of 83.5%. Its reliability has been demonstrated in various clinical settings. We successfully developed a risk prediction model for PONV in patients who underwent craniotomy. This tool has been validated to have good predictive efficacy, which is helpful in helping healthcare professionals identify high-risk patients with PONV after craniotomy at an early stage and lays the foundation for the precise prevention of PONV.
(Copyright © 2026 the Author(s). Published by Wolters Kluwer Health, LLC.)
Competing Interests: The authors have no conflicts of interest to declare.
References: Gan TJ, Belani KG, Bergese S, et al. Fourth consensus guidelines for the management of postoperative nausea and vomiting. Anesth Analg. 2020;131:411–48.
Kovac AL. Update on the management of postoperative nausea and vomiting. Drugs. 2013;73:1525–47.
Jangra K, Kumari K, Panda NB, Samagh N, Luthra A. Postoperative nausea and vomiting in neurosurgical patients: current concepts and management. Neurol India. 2018;66:1117–23.
Elvir-Lazo OL, White PF, Yumul R, Cruz Eng H. Management strategies for the treatment and prevention of postoperative/postdischarge nausea and vomiting: an updated review. F1000Res. 2020;9:F1000Faculty Rev-983.
Xu M, Zhou S, Jiang C, et al. The effects of P6 electrical acustimulation on postoperative nausea and vomiting in patients after infratentorial craniotomy. J Neurosurg Anesthesiol. 2012;24:312–6.
von Peltz CA, Baber C, Nou SLH. Australian perspective on Fourth Consensus Guidelines for the management of postoperative nausea and vomiting. Anaesth Intensive Care. 2021;49:253–6.
Chinese Glioma Committee of Chinese Medical Doctor Association. Chinese expert consensus on enhanced recovery after surgery (ERAS) in neurosurgery. Chin J Neurosurg. 2020;36:973–83.
Nilsson I, Karlsson A, Lindgren L, Bergenheim T, Koskinen L-O, Nilsson U. The efficacy of P6 acupressure with sea-band in reducing postoperative nausea and vomiting in patients undergoing craniotomy: a randomized, double-blinded, placebo-controlled study. J Neurosurg Anesthesiol. 2015;27:42–50.
Tsaousi GG, Pourzitaki C, Bilotta F. Prophylaxis of postoperative complications after craniotomy. Curr Opin Anaesthesiol. 2017;30:534–9.
Meng L, Quinlan JJ. Assessing risk factors for postoperative nausea and vomiting: a retrospective study in patients undergoing retromastoid craniectomy with microvascular decompression of cranial nerves. J Neurosurg Anesthesiol. 2006;18:235–9.
Latz B, Mordhorst C, Kerz T, et al. Postoperative nausea and vomiting in patients after craniotomy: incidence and risk factors. J Neurosurg. 2011;114:491–6.
Sato K, Sai S, Adachi T. Is microvascular decompression surgery a high risk for postoperative nausea and vomiting in patients undergoing craniotomy? J Anesth. 2013;27:725–30.
Wang L, Cai H, Wang Y, et al. Enhanced recovery after elective craniotomy: a randomized controlled trial. J Clin Anesth. 2022;76:110575.
Uribe AA, Stoicea N, Echeverria-Villalobos M, et al. Postoperative nausea and vomiting after craniotomy: an evidence-based review of general considerations, risk factors, and management. J Neurosurg Anesthesiol. 2021;33:212–20.
Burkhardt T, Czorlich P, Mende KC, et al. Postoperative nausea and vomiting following craniotomy: risk factors and complications in context of perioperative high-dose dexamethasone application. J Neurol Surg A Cent Eur Neurosurg. 2019;80:381–6.
Huang J, Yang J, Qi H, et al. Development and validation of a nomogram for predicting critical respiratory events during early anesthesia recovery in elderly patients. BMC Med Inform Decis Mak. 2024;24:257.
Bergese SD, Antor MA, Uribe AA, Yildiz V, Werner J. Triple therapy with scopolamine, ondansetron, and dexamethasone for prevention of postoperative nausea and vomiting in moderate to high-risk patients undergoing craniotomy under general anesthesia: a pilot study. Front Med (Lausanne). 2015;2:40.
Hellickson JD, Worden WR, Ryan C, et al. Predictors of postoperative nausea and vomiting in neurosurgical patients. J Neurosci Nurs. 2016;48:352–7.
Gupta P, Sabharwal N, Kale S, Gupta M, Gogia AR. Granisetron versus ondansetron for post-operative nausea and vomiting prophylaxis in elective craniotomies for brain tumors: a randomized controlled double-blind study. Anesth Essays Res. 2014;8:72–7.
Collins AS. Postoperative nausea and vomiting in adults: implications for critical care. Crit Care Nurse. 2011;31:36–45.
Echeverria-Villalobos M, Fiorda-Diaz J, Uribe A, Bergese SD. Postoperative nausea and vomiting in female patients undergoing breast and gynecological surgery: a narrative review of risk factors and prophylaxis. Front Med (Lausanne). 2022;9:909982.
Pota V, Coletta F, Pascazio F, et al. Neuroendoscopy and postoperative nausea and vomiting: pathophysiology, incidence and management strategies. Brain Sci. 2025;15:586.
Pierre S, Whelan R. Nausea and vomiting after surgery. Contin Educ Anaesth Crit Care Pain. 2013;13:28–32.
Murphy MJ, Hooper VD, Sullivan E, Clifford T, Apfel CC. Identification of risk factors for postoperative nausea and vomiting in the perianesthesia adult patient. J Perianesth Nurs. 2006;21:377–84.
Yun G, Baek SH, Kim S. Evaluation and management of hypernatremia in adults: clinical perspectives. Korean J Intern Med. 2023;38:290–302.
Kim TK, Yoon JR, Kim YS, et al. Pneumocephalus and headache following craniotomy during the immediate postoperative period. BMC Surg. 2022;22:252.
Samadani U, Huang JH, Baranov D, Zager EL, Grady MS. Intracranial hypotension after intraoperative lumbar cerebrospinal fluid drainage. Neurosurgery. 2003;52:148–51; discussion 151–2.
Hong B, Biertz F, Raab P, et al. Normobaric hyperoxia for treatment of pneumocephalus after posterior fossa surgery in the semisitting position: a prospective randomized controlled trial. PLoS One. 2015;10:e0125710.
Rüsch D, Eberhart LHJ, Wallenborn J, Kranke P. Nausea and vomiting after surgery under general anesthesia. Dtsch Arztebl Int. 2010;107:733–41.
Contributed Indexing: Keywords: craniotomy; neurosurgery; postoperative nausea and vomiting (PONV); prediction model; risk factors
Entry Date(s): Date Created: 20260822 Date Completed: 20260822 Latest Revision: 20260918
Update Code: 20260918
PubMed Central ID: PMC13502832
DOI: 10.1097/MD.0000000000050193
PMID: 42629685
Βάση Δεδομένων: MEDLINE
Περιγραφή
ISSN:1536-5964
DOI:10.1097/MD.0000000000050193