胰十二指肠切除术后胃排空延迟风险预测模型的构建及评价

Construction and evaluation of a risk prediction model for DGE after pancreaticoduodenectomy

目的研究胰十二指肠切除术后胃排空延迟(DGE)的影响因素,建立风险预测模型并评价模型的效能。方法选择2017年1月至2021年9月福建省肿瘤医院行胰十二指肠切除术患者169例,分析DGE的独立危险因素,使用R软件建立列线图模型并验证预测效果。结果单因素分析结果表明DGE与身体质量指数(BMI)、糖尿病、术前焦虑、上腹部手术史、手术时间、保留幽门有关(P<0.05)。多因素分析结果显示:糖尿病、术前焦虑、上腹部手术史、手术时间、保留幽门是DGE的独立危险因素(P<0.05)。建立列线图模型C-index为0.712,校准曲线表明模型的预测结果和观察结果拟合较好。结论本研究建立的列线图模型有效预测DGE的发生风险。

Objective To investigate the factors influencing delayed gastric emptying(DGE)after pancreaticoduodenectomy,and to construct a risk prediction model and evaluate the efficiency of the model.Methods A total of 169 patients undergoing pancreaticoduodenectomy in Fujian Cancer Hospital from January 2017 to September 2021 were included in this study.The independent risk factors for DGE were analyzed,and a nomogram model was constructed using R software and was evaluated for predictive effect.Results Univariate analysis showed that DGE was associated with body mass index(BMI),diabetes mellitus,preoperative anxiety,history of upper abdominal surgery,duration of surgery,and pylorus preservation(P<0.05).Multivariate analysis showed that diabetes mellitus,preoperative anxiety,history of upper abdominal surgery,duration of surgery,and pylorus preservation were independent risk factors for DGE(P<0.05).A nomogram model was constructed with a C-index of 0.712,and the calibration curve indicated a good fit between the predicted and observed outcomes of the model.Conclusion The nomogram model constructed in this study is effective in predicting the risk of DGE.