摘要
目的:探讨急性阑尾炎患者并发肠梗阻的影响因素,并依此构建列线图预测模型。方法:选取本院2019年8月—2022年3月收治的395例急性阑尾炎患者的临床资料,根据患者是否并发肠梗阻将其分为并发组(22例)和未并发组(373例),比较两组患者一般资料,采用多因素Logistic回归分析法分析急性阑尾炎患者并发肠梗阻的影响因素并绘制列线图,用受试者工作特征(ROC)曲线评估列线图的预测效能,Bootstrap法验证模型的校准度。结果:不同病理类型急性阑尾炎患者白细胞计数和中性粒细胞计数比较差异有统计学意义(P<0.05);回肠前位/后位病变、有阑尾周围积液、发病至就诊时长、有低钾血症、白细胞计数和中性粒细胞计数高均为影响急性阑尾炎患者并发肠梗阻的危险因素(P<0.05)。ROC曲线分析显示,本研究构建的列线图模型预测急性阑尾炎患者并发肠梗阻的曲线下面积(AUC)、灵敏度和特异度分别为0.830(95%CI:0.788~0.866)、77.27%和85.52%;经Bootstrap法进行内部验证,其一致性指数(C-index)为0.837。结论:基于危险因素构建的列线图模型具有良好的校准度,有助于在急性阑尾炎患者中筛选出并发肠梗阻患者。
Objective To investigate the influencing factors of intestinal obstruction in patients with acute appendicitis,and to establish a line chart prediction model.Methods The clinical data of 395 patients with acute appendicitis admitted to our hospital from August 2019 to March 2022 were selected.The patients were divided into the concurrent group(n=22)and the non-concurrent group(n=373)according to whether they had intestinal obstruction.The general data of the two groups were compared.Multivariate Logistic regression analysis was used to analyze the influencing factors of intestinal obstruction in patients with acute appendicitis and to draw a nomogram.The predictive efficacy and calibration of the nomogram were evaluated by receiver operating characteristic(ROC)curve and Bootstrap method.Results The white blood cell count and neutrophil count of patients with different pathological types of acute appendicitis were significantly different(P<0.05).The anterior/posterior ileal lesions,periappendiceal effusion,time from onset to visit,hypokalemia,white blood cell count and neutrophil count were risk factors for intestinal obstruction in patients with acute appendicitis(P<0.05).ROC curve analysis showed that the area under the curve(AUC),sensitivity and specificity of the risk prediction model of intestinal obstruction in patients with acute appendicitis were 0.830(95%CI:0.788-0.866),77.27%and 85.52%,respectively.After internal verification by Bootstrap method,the consistency index(C-index)was 0.837.Conclusion The nomogram model based on risk factors had good calibration and is helpful in screening patients with acute appendicitis complicated with intestinal obstruction.
作者
孙华翠
赵得银
刘思义
SUN Hua-cui;ZHAO De-yin;LIU Si-yi(Suzhou Hospital Affiliated to Anhui Medical University,Suzhou(234000),China)
出处
《中国中西医结合外科杂志》
CAS
2023年第1期84-88,共5页
Chinese Journal of Surgery of Integrated Traditional and Western Medicine
基金
宿州市科技计划项目(SZSKJJZC020)。
关键词
急性阑尾炎
肠梗阻
列线图
预测模型
Acute appendicitis
intestinal obstruction
the column chart
prediction model
