Construction and validation of a nomogram model for early ostomy complications after Miles surgery for rectal cancer
10.3760/cma.j.cn115682-20221121-05612
- VernacularTitle:直肠癌Miles术后早期造口并发症列线图预测模型的构建与验证
- Author:
Yi ZHANG
1
;
Yan LIU
;
Yaxin CHAI
;
Xiaojing LIU
Author Information
1. 新乡市中心医院普通外科三（肛肠），新乡 453000
- Keywords:
Rectal neoplasms;
Miles surgery;
Early ostomy complications;
Nomogram prediction model
- From:
Chinese Journal of Modern Nursing
2023;29(32):4417-4422
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To analyze the risk factors for early ostomy complications after Miles surgery for rectal cancer and construct a nomogram model.Methods:A case-control study method was used to collect clinical data of 205 patients who underwent Miles surgery for rectal cancer at Xinxiang Central Hospital from January 2019 to January 2022. Patients were divided into early ostomy complications group and no early ostomy complications group based on whether early ostomy complications occurred. Single factor analysis and multivariate Logistic regression analysis were used to determine the influencing factors for early ostomy complications after Miles surgery for rectal cancer. R language was used to construct a nomogram model for early ostomy complications after Miles surgery for rectal cancer. The area under the receiver operating characteristic curve (ROC) was used to evaluate the predictive performance of the nomogram model. By drawing a calibration map for consistency testing, the Hosmer-Lemeshow test was used to determine the goodness of fit of the model. P>0.05 indicated a good fit of the model. R software was used to randomly select 30% of cases as validation groups for internal validation. Results:This study included a total of 205 patients, including 115 males and 90 females. Among them, 37 had early ostomy complications, with an incidence of 18.0%. The results of multivariate Logistic regression analysis showed that failure to receive rapid surgical rehabilitation nursing [ OR=2.779, 95% CI (1.144, 6.750) ], age ≥65 years old [ OR=2.862, 95% CI (1.186, 6.906) ], albumin<35 g/L [ OR=3.414, 95% CI (1.373, 8.488) ], and failure to locate the preoperative ostomy position [ OR=4.846, 95% CI (1.488, 15.776) ] were risk factors for early ostomy complications after Miles surgery for rectal cancer, and the differences were statistically significant ( P<0.05) . Based on this result, a prediction model was constructed, with an area under the ROC curve of 0.801 [95% CI (0.713, 0.868) ]. After internal validation, the area under the ROC curve of the validation group was 0.807 [95% CI (0.641, 0.973) ]. The calibration curves of the modeling group ( P=0.980) and the validation group ( P=0.981) showed a good coincidence between the predicted results and the actual results. Conclusions:Failure to receive rapid surgical rehabilitation nursing, age ≥65 years old, albumin<35 g/L, and failure to locate the preoperative ostomy position are risk factors for early ostomy complications after Miles surgery for rectal cancer. This study constructs a nomogram model based on the results of Logistic regression analysis, which can effectively predict the probability of early ostomy complications after Miles surgery for rectal cancer. For high-risk patients, individualized intervention should be carried out as soon as possible to reduce the incidence of ostomy complications and improve the patient's quality of life.
