结直肠癌术后腹腔感染的危险因素及风险模型建立

Risk factors for postoperative abdominal infection in patients with colorectal cancer and establishment of risk model

  • 摘要:
    目的 分析结直肠癌术后患者腹腔感染的临床特征及危险因素, 并构建风险预测模型。
    方法 选取2020年1月-2022年12月东营市东营区人民医院收治的179例结直肠癌行手术治疗患者, 根据术后是否发生腹腔感染分为感染组43例和未感染组136例, 回顾性收集患者临床资料, 多因素Logistic回归分析结直肠癌患者术后腹腔感染的危险因素, 构建风险预测模型并评估其预测价值。
    结果 Logistic回归分析结果显示, 合并糖尿病、有低蛋白血症、术后造口、留置引流管时间≥10 d与结直肠癌术后腹腔感染有关(P<0.05);构建的预测模型:Logit(P)=-2.410+合并糖尿病×1.031+低蛋白血症×0.919+术后造口×0.987+留置引流管时间×1.000, Hosmer-Lemeshow拟合优度检验显示模型拟合效果较好(Chi-Square=3.412, P =0.578), 校准曲线结果显示, 预测概率与实际概率接近, 提示该回归模型具有良好的区分、校准和预测能力, 受试者工作特征(ROC)曲线分析结果显示, 模型预测结直肠癌术后腹腔感染的曲线下面积(AUC)值为0.828。
    结论 结直肠癌术后腹腔感染与合并糖尿病、有低蛋白血症、术后造口、留置引流管时间有关, 据此构建的风险预测模型具有较好的预测价值。

     

    Abstract:
    OBJECTIVE To investigate the clinical characteristics and risk factors for the postoperative abdominal infection in the patients with colorectal cancer and establish the risk prediction model.
    METHODS Totally 179 colorectal cancer patients who received surgical procedures in Dongying District People′s Hospital from Jan 2020 to Dec 2022 were enrolled in the study and were divided into the infection group with 43 cases and the no infection group with 136 cases according to the status of postoperative abdominal infection. The clinical data were retrospectively collected from the patients, multivariate logistic regression analysis was performed for the risk factors for the postoperative abdominal infection, the risk prediction model was established, and the predictive value of the model was evaluated.
    RESULTS The result of logistic regression analysis showed that the postoperative abdominal infection was associated with the complication with diabetes mellitus, hypoproteinemia, postoperative stoma and drainage tube indwelling time no less than 10 days(P < 0.05). The established prediction model was as follows: Logit(P)=-2.410+complication with diabetes mellitus×1.031+hypoproteinemia×0.919+postoperative stoma×0.987+drainage tube indwelling time×1.000; Hosmer-Lemeshow test of goodness of fit showed that the model had favorable fitting effect(Chi-Square=3.412, P=0.578), the result of calibration curve showed that the predicted probability approximated to the actual probability, indicating that the model had favorable capability of differentiation, calibration and prediction. Receiver operating characteristic (ROC) curve analysis showed that the area under curve (AUC) of the model was 0.828 in prediction of postoperative abdominal infection in the colorectal cancer patients.
    CONCLUSION The postoperative abdominal infection in the colorectal cancer patients is associated with the complication with diabetes mellitus, hypoproteinemia, postoperative stoma and drainage tube indwelling time. The risk prediction model has high predictive value.

     

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