膀胱癌根治术后患者出现肠梗阻的列线图预测模型

A nomogram predictive model of ileus after radical cystectomy

目的分析膀胱癌根治术后患者发生肠梗阻的危险因素,并依据危险因素构建术后肠梗阻列线图预测模型。方法收集2018年1月-2021年12月于贵州省人民医院泌尿外科行根治术的膀胱癌患者的临床资料,使用Logitic单因素及多因素回归分析得到膀胱癌根治术后患者发生肠梗阻的危险因素,然后根据危险因素构建膀胱癌根治术后患者发生肠梗阻的列线图预测模型并验证其辨识能力及准确度。结果最终纳入326例患者,其中65例在术后发生肠梗阻。经统计学分析发现膀胱癌根治术后发生肠梗阻与性别、是否行淋巴结清扫、术后血肌酐水平、术后血白蛋白等因素相关,依据以上危险因素建立列线图预测模型后,预测模型受试者工作特征曲线(ROC)的曲线下面积为0.769(95%CI:0.724~0.802),预测模型的Bootstrap校正曲线表明模型预测准确度良好。结论男性、行淋巴结清扫、术后血肌酐水平升高、术后血白蛋白下降可作为建立膀胱癌根治术后发生肠梗阻的临床预测模型的预测因子,根据这些预测因子建立的列线图预测模型可以预测患者在膀胱癌根治术后发生肠梗阻的概率。

Objective To analyze the risk factors of ileus after radical cystectomy,and to construct a nomogram predictive model accordingly.Methods Clinical data of patients who underwent radical cystectomy during Jan.2018 and Dec.2021 were collected.The risk factors related to postoperative ileus were assessed with Logistic univariate and multivariate regression analysis.After that,the predictive model was constructed and its specificity and accuracy were verified.Results A total of 326 patients were included,65 of whom developed ileus.Statistical analysis showed that gender,lymph node dissection,serum creatinine and albumin were correlated with postoperative ileus.The area under the receiver operating characteristic curve of the model was 0.769(95%CI:0.724-0.802).Bootstrap correction curve showed that the model had good prediction accuracy.Conclusion Male,lymph node dissection,elevated postoperative serum creatinine and postoperative blood albumin decrease are predictors of ileus.The nomogram predictive model based on these predictors can predict the probability of ileus after radical cystectomy.