Construction and validation of a clinical prediction model for early postoperative parastomal hernia in patients with enterostomy
10.3760/cma.j.cn115682-20220311-01122
- VernacularTitle:肠造口患者术后早期造口旁疝临床预测模型构建及验证
- Author:
Min DING
1
;
Yan WU
;
Weiling SUN
;
Birong QI
;
Yi SUN
;
Jingzhi PU
;
Jian GAO
Author Information
1. 复旦大学附属中山医院护理部，上海 200032
- Keywords:
Enterostomy;
Parastomal hernia;
Clinical prediction model;
Nomogram
- From:
Chinese Journal of Modern Nursing
2022;28(26):3540-3545
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To construct a clinical prediction model for early postoperative parastomal hernia in patients with enterostomy and to conduct internal and external validation and evaluation of clinical benefit.Methods:A total of 1 071 patients with enterostomy treated in Zhongshan Hospital Affiliated to Fudan University from October 2013 to December 2020 were selected as the research objects by the convenient sampling method. Patients from October 2013 to December 2019 were selected as the modeling group ( n=943) . The data of patients were obtained by questionnaire and other methods. The clinical prediction model of early postoperative parastomal hernia in patients with enterostomy was constructed based on Cox regression analysis and the model was internally verified by Bootstrap method. Patients from January to December 2020 were selected as the validation group ( n=128) for external validation of the model. C-statistic, area under receiver operating characteristic curve and calibration map were used to evaluate the discrimination and calibration of the model. Decision curve analysis was used to draw decision curve analysis chart to evaluate the clinical benefit of the prediction model. Results:Age, history of alcohol consumption, postoperative body mass index, diabetes mellitus, respiratory diseases, history of abdominal surgery, stoma route, stoma nature and C-reactive protein were independent influencing factors for early postoperative parastomal hernia in patients with enterostomy ( P<0.05) . The C- index value of early postoperative nomogram was 0.710 (95% CI: 0.660-0.750) . Conclusions:The clinical prediction model of early parastomal hernia in patients with enterostomy has good predictive performance, which can help clinical medical staff to screen out high-risk groups in time and guide medical staff to focus on prevention.
