前列腺增生电切术术后感染列线图预测模型的建立

Establishment of Nomogram Prediction Model for Postoperative Infection after Electroresection of Prostatic Hyperplasia

目的:分析导致前列腺增生电切术术后感染的危险因素,在此基础上建立前列腺增生电切术术后感染列线图预测模型。方法:随机选取2018年7月-2021年1月于本院行前列腺增生电切术术后感染和未感染的患者各40例进行回顾性分析,将感染患者作为研究组,未感染患者作为对照组。对其临床资料进行Logistic回归分析,找出术后感染的危险因素,通过R软件进行列线图预测模型的建立,并通过ROC曲线进行验证。结果:经Logistic回归分析发现,年龄>65岁、手术时间>1.5 h、合并糖尿病、术前行导尿术及术后导尿管留置时间>5 d均为导致前列腺增生电切术术后感染的独立危险因素(P<0.05);列线图模型预测前列腺增生电切术术后感染风险的一致性指数为0.726,具有良好的区分度;对列线图预测术后感染风险的效率进行ROC曲线分析,曲线下面积为0.735,95%置信区间为0.672,0.827。结论:前列腺增生电切术术后感染的独立危险因素为年龄>65岁、手术时间>1.5 h、合并糖尿病、术前行导尿术及术后导尿管留置时间>5 d,且基于此建立的列线图预测模型准确度和区分度均较高,对临床上鉴别高风险人群具有指导意义。

Objective:To analyze the risk factors of postoperative infection in patients with prostatic hyperplasia after transurethral resection of prostate,and to establish a nomogram prediction model for postoperative infection after transurethral resection of prostate.Method:A total of 40 cases of infected patients and 40 cases of uninfected patients after electroresection of prostatic hyperplasia in our hospital from July 2018 to January 2021 were randomly select for retrospective analysis.The infected patients were treated as the study group and the uninfected patients as the control group.Logistic regression analysis was performed on the clinical data to find out the risk factors of postoperative infection.The nomogram prediction model was established by R software and verified by ROC curve.Result:Logistic regression analysis showed that age>65 years old,operation time>1.5 h,diabetes mellitus,preoperative catheterization and postoperative catheter indwelling time>5 d were all independent risk factors for postoperative infection after electroresection of prostatic hyperplasia (P<0.05);the consistency index of nomogram model for predicting the risk of postoperative infection after electroresection of prostatic hyperplasia was 0.726,which had good discrimination;the efficiency of nomogram in predicting postoperative infection risk was analyzed by ROC curve,the area under the curve was 0.735,and the 95% confidence interval was 0.672,0.827.Conclusion:The independent risk factors of infection after electroresection of prostatic hyperplasia are age>65 years old,operation time>1.5 h,diabetes mellitus,catheterization before operation and indwelling time of catheter after operation > 5 d.The nomogram prediction model based on those has high accuracy and discrimination,which has guiding significance for the clinical identification of high-risk population.