Predicting postoperative nausea and vomiting after cesarean section: a nomogram model combined with gastric ultrasound

Abstract Background To investigate the independent risk factors associated with postoperative nausea and vomiting (PONV) following Cesarean section procedures, and establish and validate a nomogram to predict them. Methods The clinical data of 116 adult patients who underwent Cesarean section proced...

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Main Authors: Yingchao Liu, Huohu Zhong, Zhisen Dai, Yuxin Huang, Yibin Liu, Hefan He, Yuewen Liao, Weifeng Liu
Format: Article
Language:English
Published: BMC 2025-02-01
Series:BMC Anesthesiology
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Online Access:https://doi.org/10.1186/s12871-025-02936-z
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author Yingchao Liu
Huohu Zhong
Zhisen Dai
Yuxin Huang
Yibin Liu
Hefan He
Yuewen Liao
Weifeng Liu
author_facet Yingchao Liu
Huohu Zhong
Zhisen Dai
Yuxin Huang
Yibin Liu
Hefan He
Yuewen Liao
Weifeng Liu
author_sort Yingchao Liu
collection DOAJ
description Abstract Background To investigate the independent risk factors associated with postoperative nausea and vomiting (PONV) following Cesarean section procedures, and establish and validate a nomogram to predict them. Methods The clinical data of 116 adult patients who underwent Cesarean section procedures between August 2022 and February 2023 were included. Participants were randomly divided into training (n = 87) and verification sets (n = 29) in a 3:1 ratio. Univariate and multivariate logistic regression were used to analyze the risk factors for PONV following Cesarean sections and the independent risk factors were then used for the prediction model. Simultaneously, 29 adult patients who underwent caesarean section between February 2023 and April 2023 were included in the hospital as a test set to conduct external verification of the nomogram and Apfel scoring models, and compare their diagnostic efficacy in predicting PONV after caesarean section. Results A history of motion sickness, systolic blood pressure reduction > 20%, and gastric volume were independent risk factors for PONV and used to construct the model. The AUC for predicting the risk of PONV in the training and validation sets was 0.814 (95% confidence interval [CI] = 0.709–0.918) and 0.792 (95% CI = 0.621–0.962), respectively. In the test set, the AUCs of the nomogram and the Apfel scoring models were 0.779 (95% CI = 0.593–0.965) and 0.547 (95% CI = 0.350–0.745), respectively, with the former being significantly higher (Z = 2.165, P < 0.05). Conclusions Our nomogram model was superior to the Apfel scoring model and may be helpful in formulating appropriate individualized management strategies for nausea and vomiting following Cesarean sections, to promote the rapid recovery of patients.
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spelling doaj-art-86169e0cd354495e8f3ef0c46b87dc752025-02-09T12:52:01ZengBMCBMC Anesthesiology1471-22532025-02-0125111110.1186/s12871-025-02936-zPredicting postoperative nausea and vomiting after cesarean section: a nomogram model combined with gastric ultrasoundYingchao Liu0Huohu Zhong1Zhisen Dai2Yuxin Huang3Yibin Liu4Hefan He5Yuewen Liao6Weifeng Liu7Department of Anesthesiology, Clinical Oncology School of Fujian Medical University, Fujian Cancer HospitalDepartment of Ultrasound, The Second Affiliated Hospital of Fujian Medical UniversityDepartment of Anesthesiology, Clinical Oncology School of Fujian Medical University, Fujian Cancer HospitalDepartment of Anesthesiology, the Second Affiliated Hospital of Fujian Medical UniversityDepartment of Anesthesiology, the Second Affiliated Hospital of Fujian Medical UniversityDepartment of Anesthesiology, the Second Affiliated Hospital of Fujian Medical UniversityDepartment of Anesthesiology, the Second Affiliated Hospital of Fujian Medical UniversityDepartment of Anesthesiology, the Second Affiliated Hospital of Fujian Medical UniversityAbstract Background To investigate the independent risk factors associated with postoperative nausea and vomiting (PONV) following Cesarean section procedures, and establish and validate a nomogram to predict them. Methods The clinical data of 116 adult patients who underwent Cesarean section procedures between August 2022 and February 2023 were included. Participants were randomly divided into training (n = 87) and verification sets (n = 29) in a 3:1 ratio. Univariate and multivariate logistic regression were used to analyze the risk factors for PONV following Cesarean sections and the independent risk factors were then used for the prediction model. Simultaneously, 29 adult patients who underwent caesarean section between February 2023 and April 2023 were included in the hospital as a test set to conduct external verification of the nomogram and Apfel scoring models, and compare their diagnostic efficacy in predicting PONV after caesarean section. Results A history of motion sickness, systolic blood pressure reduction > 20%, and gastric volume were independent risk factors for PONV and used to construct the model. The AUC for predicting the risk of PONV in the training and validation sets was 0.814 (95% confidence interval [CI] = 0.709–0.918) and 0.792 (95% CI = 0.621–0.962), respectively. In the test set, the AUCs of the nomogram and the Apfel scoring models were 0.779 (95% CI = 0.593–0.965) and 0.547 (95% CI = 0.350–0.745), respectively, with the former being significantly higher (Z = 2.165, P < 0.05). Conclusions Our nomogram model was superior to the Apfel scoring model and may be helpful in formulating appropriate individualized management strategies for nausea and vomiting following Cesarean sections, to promote the rapid recovery of patients.https://doi.org/10.1186/s12871-025-02936-zPostoperative nausea and vomitingCesarean sectionNomogramGastric ultrasound
spellingShingle Yingchao Liu
Huohu Zhong
Zhisen Dai
Yuxin Huang
Yibin Liu
Hefan He
Yuewen Liao
Weifeng Liu
Predicting postoperative nausea and vomiting after cesarean section: a nomogram model combined with gastric ultrasound
BMC Anesthesiology
Postoperative nausea and vomiting
Cesarean section
Nomogram
Gastric ultrasound
title Predicting postoperative nausea and vomiting after cesarean section: a nomogram model combined with gastric ultrasound
title_full Predicting postoperative nausea and vomiting after cesarean section: a nomogram model combined with gastric ultrasound
title_fullStr Predicting postoperative nausea and vomiting after cesarean section: a nomogram model combined with gastric ultrasound
title_full_unstemmed Predicting postoperative nausea and vomiting after cesarean section: a nomogram model combined with gastric ultrasound
title_short Predicting postoperative nausea and vomiting after cesarean section: a nomogram model combined with gastric ultrasound
title_sort predicting postoperative nausea and vomiting after cesarean section a nomogram model combined with gastric ultrasound
topic Postoperative nausea and vomiting
Cesarean section
Nomogram
Gastric ultrasound
url https://doi.org/10.1186/s12871-025-02936-z
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