Construction and validation of a risk predictive model for the bowel preparation failure in colonoscopy patients
10.3761/j.issn.0254-1769.2024.09.010
- VernacularTitle:结肠镜检查患者肠道准备失败风险预测模型的构建及验证
- Author:
Ya LIU
1
;
Xiaoqing LIU
;
Xuening YANG
;
Ping WANG
;
Xuekui LIU
;
Dan LUO
Author Information
1. 221009 徐州市,徐州市中心医院护理部
- Keywords:
Colonoscopy;
Stool Form;
Risk Factors;
Nomogram;
Prediction Model;
Nursing Care
- From:
Chinese Journal of Nursing
2024;59(9):1091-1098
- CountryChina
- Language:Chinese
-
Abstract:
Objective To analyze the predictive value of fecal form for the quality of bowel preparation in patients scheduled for colonoscopy,identify risk factors for bowel preparation failure,and develop and validate a risk prediction model.Methods This was a prospective cohort study using convenience sampling.Patients scheduled for colonoscopy in the Digestive Department of a tertiary A hospital in Jiangsu Province from June to December 2022 were included in the modeling cohort.General information sheet and the Bristol Stool Form Scale(BSFS)were used for data collection.Patients were categorized into a successful bowel preparation group and a bowel preparation failure group based on the quality of bowel preparation.The optimal cutoff value for BSFS was determined using the best cutoff value method.Logistic regression analysis was employed to identify risk factors for bowel preparation failure,and a nomogram risk prediction model was constructed.Patients undergoing colonoscopy in the same hospital from January to February 2023 were served as the validation cohort.Results The modeling cohort included 569 patients,and the validation cohort included 212 patients,with bowel preparation failure rates of 19.0％and 19.8％,respectively.The risk prediction model formula derived from logistic regression analysis was P=-2.209+0.619 × hospitalized patients+0.635 × age≥65 years-0.710 × previous colonoscopy history+2.031 × BSFS type 1～2.The area under the receiver operating characteristic curve for the model was 0.751,with a sensitivity of 54.6％,a specificity of 85.9％,and the optimal cutoff value was 0.225,corresponding to a risk score of 80 for bowel preparation failure.The Hosmer-Lemeshow test showed x2=4.429,P=0.351.External validation demonstrated an area under the receiver operating characteristic curve of 0.775,indicating good model fit and high predictive value.Conclusion The incidence of bowel preparation failure in colonoscopy patients is relatively high.Patients aged 65 years,hospitalized patients,those with no history of colonoscopy,and those with BSFS type 1～2 are more likely to experience bowel preparation failure.The risk prediction model developed in this study has good predictive performance and can provide a basis for clinical nurses to quickly assess the risk of bowel preparation failure in patients.
