Risk factors for the development of postoperative infective endophthalmitis in elderly cataract patients: analysis of the nomogram and development of a nomogram model
10.3760/cma.j.cn115455-20221202-01061
- VernacularTitle:老年性白内障患者术后发生感染性眼内炎的危险因素分析及列线图模型的建立
- Author:
Siying CHEN
1
;
Yingying CHEN
;
Qionglei ZHONG
Author Information
1. 海南省人民医院眼科，海口 571000
- Keywords:
Cataract;
Infective endophthalmitis;
Risk factors;
Nomogram model
- From:
Chinese Journal of Postgraduates of Medicine
2024;47(7):605-610
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To analyze the risk factors for the development of postoperative infective endophthalmitis in elderly cataract patients and to establish a nomogram model.Methods:Five hundred patients who underwent ultrasonic cataract aspiration in Hainan Provincial People′s Hospital from October 2020 to March 2021 were collected for the study. The patients were divided into infective endophthalmitis group (50 cases) and non-infection group (450 cases) according to whether infective endophthalmitis occurred. The clinical data of patients in both groups were recorded, and relevant factors affecting the occurrence of infective endophthalmitis were analyzed; receiver operating characteristic (ROC) curve was used to analyze the predictive value of indicators with statistically significant differences for the occurrence of infective endophthalmitis; Logistic regression was used to analyze independent risk factors for postoperative infective endophthalmitis; R language software 4.0 "rms" package to construct a nomogram model for predicting the occurrence of infective endophthalmitis, calibration and decision curves for internal validation and assessment of predictive efficacy.Results:Compared to the non-infected endophthalmitis group, patients in the infected endophthalmitis group were older: (70.44 ± 9.46) years vs. (64.54 ± 6.02) years, with longer hospital stay: (3.34 ± 0.92) d vs. (2.53 ± 0.78) d, longer surgical time: (62.58 ± 6.78) min vs. (56.69 ± 4.31) min; hypertension: 72.00% (36/50) vs. 48.89% (220/450), diabetes mellitus: 66.00% (33/50) vs. 33.33% (150/450), vitreous overflow: 78.00% (39/50) vs. 48.89% (220/450), and a higher percentage of posterior lens capsule rupture: 82.00% (41/50) vs. 53.33% (240/450), with a statistically significant difference ( P<0.05). The area under curve for age, length of hospital stay, and operative time were 0.709, 0.744 and 0.757, respectively; the best cutoff values were 69 years, 3.27 d and 62.75 min. The age (>69 years), diabetes mellitus (yes), surgical incision location (clear cornea), operative time (>62.75 min), vitreous overflow (yes), and posterior lens capsule rupture (yes) were independent risk factors for postoperative infective endophthalmitis in elderly cataract patients. the C-index of the nomogram model for predicting infective endophthalmitis was 0.675 (95% CI 0.653 to 0.724) with a threshold>0.18. The nomogram model provided a net clinical benefit and all of the nomogram model net clinical benefits were higher than the independent predictors. Conclusions:The nomogram model constructed based on age, diabetes, surgical incision location, time of surgery, vitreous overflow and posterior lens capsule rupture can be used for early identification of risk factors for postoperative infective endophthalmitis in clinical elderly cataract patients, with good clinical efficacy.
