某三级甲等医院胃肠外科术后并发症影响因素分析

Analysis of Influencing Factors of Postoperative Complications of Gastrointestinal Surgery in a TertiaryGrade A Hospital

目的分析某三级甲等医院胃肠外科三、四级手术术后并发症的影响因素。方法抽取某三级甲等医院2019年1月—2021年12月胃肠外科356例病例,采用单因素分析、二元logistic回归分析和决策树模型等进行分析。结果二元logistic回归分析结果显示,身体质量指数(BMI)、手术级别、手术方式、是否输血、是否造口是术后并发症的独立影响因素。分类决策树模型显示:树分为3层、13个节点和7个终端节点,第1层为是否造口,第2层为BMI、是否输血,第3层为术中出血、是否合并糖尿病、手术级别。两种模型预效果比较显示,ROC曲线下面积均超过0.7,差异有统计学意义(P<0.001),模型预测具有准确性。结论两种模型具有互补性,互相结合用于评估术后并发症风险具有应用价值,建议胃肠外科根据术后并发症风险因素做好术前评估及围手术期管理,防范术后并发症的发生。

Objective To analysis the influencing factors of postoperative complications of gastrointestinal surgery in a tertiary grade A hospital.Methods A total of 356 cases of gastrointestinal from January 2019 to December 2021 in a tertiary grade A hospital were analyzed by univariate analysis,binary logistic regression and decision tree model.Resu lts Binary logistic regression showed that BMI,grade,surgery,blood transfusion and stoma were independent risk factors for postoperative complications.The classified decision tree model shows that the tree is divided into 3 layers,13 nodes and 7 terminal nodes,the first layer is stoma or not,the second layer is BMI,blood transfusion or not,the third level is bleeding during operation,diabetes melitus or not,and the level of operation.The area un-der the ROC curve was more than 0.7(P<0.001),which indicated the accuracy of the two models.Conclusion The two models are complementary to each other,and the combination of the two models is of practical value in evaluating the nisk of postoperative complications.It is suggested that gastrointestinal surgery should do well in preoperative evaluation and peroperative management according to the nisk factors of postoperative complications,prevent the occurence of postoperative complications.