消化内镜术后并发尿潴留影响因素及预测模型

Influencing Factors and Prediction Model of Postoperative Urinary Retention Following Gastrointestinal Endoscopy

目的探讨消化内镜术后并发尿潴留的影响因素并构建预测模型。方法回顾性分析2021年6月至2022年8月于四川大学华西医院行消化内镜手术的393例患者的临床资料。根据患者在消化内镜手术后是否发生尿潴留分为尿潴留组(n=57)与对照组(n=336)。采用多因素logistic回归分析消化内镜术后并发尿潴留的影响因素,并构建预测模型,采用受试者操作特征(ROC)曲线分析模型的预测价值。结果男性(OR=9.548)、年龄(OR=1.056)、麻醉时长≥2 h(OR=3.493)是消化内镜术后发生尿潴留的危险因素(P<0.05)。构建的预测模型ROC曲线下面积(AUC)为0.942(95%CI=0.912~0.971,P<0.001),灵敏度为89.47%,特异度为85.71%。拟合优度检验χ^(2)=6.947,P=0.542,调整后的R2=0.621。临床验证该模型的准确率为89.23%。结论男性、年龄越大、麻醉时间越长的患者在消化内镜手术后并发尿潴留的风险越高,根据上述因素构建的预测模型对消化内镜术后并发尿潴留有较好的预测价值,可供临床借鉴。

Objective To explore the influencing factors of postoperative urinary retention following gastrointestinal endoscopy and to construct the prediction model.Methods A retrospective analysis was performed on the clinical data of 393 patients undergoing gastrointestinal endoscopy in West China Hospital of Sichuan University between June 2021 and August 2022.According to the presence or absence of postoperative urinary retention after endoscopy,they were divided into urinary retention group(n=57)and control group(n=336).The influencing factors of postoperative urinary retention were analyzed by multivariate Logistic regression analysis.The prediction model was constructed,and its predictive value was analyzed by receiver operating characteristic(ROC)curves.Results Male(OR=9.548),age(OR=1.056),and duration of anesthesia≥2h(OR=3.493)were the risk factors for postoperative urinary retention following gastrointestinal endoscopy(P<0.05).The area under ROC curve(AUC)of the prediction model was 0.942(95%CI:0.912-0.971,P<0.001).The sensitivity and specificity were 89.47%and 85.71%,respectively.The results of goodness of fit test were as follows:χ^(2)=6.947,P=0.542,adjusted R2=0.621.The accuracy of this model by clinical verification was 89.23%.Conclusion Male patients,older patients,and patients with longer duration of anesthesia have a higher risk of postoperative urinary retention following gastrointestinal endoscopy.The prediction model based on the above factors has a good predictive value for postoperative urinary retention following gastrointestinal endoscopy,which can be used for clinical reference.