{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,11]],"date-time":"2026-08-11T16:29:51Z","timestamp":1786465791367,"version":"build-2736575974"},"reference-count":36,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,8,5]],"date-time":"2026-08-05T00:00:00Z","timestamp":1785888000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Pediatr."],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Emergence agitation (EA) is a frequent recovery complication in children and may compromise postoperative safety. This study aimed to develop and internally validate an exploratory model for predicting Pediatric Anesthesia Emergence Delirium (PAED)-defined EA after laparoscopic high ligation of the hernia sac.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      This single-center retrospective prediction-model study screened 342 consecutive procedures performed from January 2022 to December 2024. Complete-case analysis included 287 children. The prediction time was immediately before planned tracheal extubation and before the first PAED assessment. After review of the original data-driven selection results, a\n                      <jats:italic>post hoc<\/jats:italic>\n                      four-predictor logistic model was constructed using age, baseline preoperative anxiety, sedative premedication, and intraoperative regional block. Conditional internal validation was performed using 1,000 bootstrap resamples.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>PAED-defined EA occurred in 93 children (32.4%). Increasing age was associated with lower odds of EA, whereas baseline preoperative anxiety was associated with higher odds; sedative premedication and intraoperative regional block were associated with lower odds. The model showed an apparent area under the receiver operating characteristic curve of 0.768 (95% confidence interval, 0.710\u20130.826) and an optimism-corrected value of 0.755. The optimism-corrected calibration slope and intercept were 0.943 and \u22120.028, respectively, and the corrected Brier score was 0.185.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>\n                      The\n                      <jats:italic>post hoc<\/jats:italic>\n                      four-predictor nomogram showed moderate discrimination and acceptable internal calibration for estimating PAED-defined EA risk. Independent external validation and prospective clinical impact assessment are required before implementation.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fped.2026.1847049","type":"journal-article","created":{"date-parts":[[2026,8,11]],"date-time":"2026-08-11T15:13:11Z","timestamp":1786461191000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["A nomogram for predicting emergence agitation after laparoscopic high ligation of the hernia sac in children"],"prefix":"10.3389","volume":"14","author":[{"given":"Chun","family":"Liang","sequence":"first","affiliation":[{"name":"Department of Anesthesiology, Jinhua Maternal & Child Health Care Hospital (Jinhua Women\u2019s and Children\u2019s Hospital)","place":["Jinhua, Zhejiang, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xifeng","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology, Children\u2019s Hospital of Nanjing Medical University","place":["Nanjing, Jiangsu, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lian","family":"Zhao","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology, Huai'an Hospital of Huai'an City, (Huai'an Clinical Medical College of Jiangsu University)","place":["Huai'an, Jiangsu, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,8,5]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"219","DOI":"10.1055\/s-0040-1721420","article-title":"Surgical management of pediatric inguinal hernia: a systematic review and guideline from the European Pediatric Surgeons\u2019 Association Evidence and Guideline Committee","volume":"32","author":"Morini","year":"2022","journal-title":"Eur J Pediatr 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