Risk factors for postoperative pain and construction and validation of prediction model in patients with mixed hemorrhoids
10.3760/cma.j.cn131073-20240914-00412
- VernacularTitle:混合痔患者术后疼痛的危险因素及预测模型的构建与验证
- Author:
Qiurui HUANG
1
;
Duanrong ZHANG
1
;
Ning WU
1
;
Xiaoming CHEN
1
;
Xuelong NIU
1
;
Fuqi XU
1
Author Information
1. 南京大学医学院附属苏州医院麻醉科，苏州 215153
- Publication Type:Journal Article
- Keywords:
Hemorrhoids;
Pain, postoperative;
Risk factors
- From:
Chinese Journal of Anesthesiology
2025;45(4):449-453
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To identify the risk factors for postoperative pain and construct a risk prediction model and validate it in the patients with mixed hemorrhoids.Methods:In this case-control study, 231 mixed haemorrhoid patients at Suzhou Hospital affiliated to Nanjing University Shool of Medicine from October 2022 to February 2024 were selected as the study subjects and divided into model group( n=161) and validation group( n=70)in a ratio of 7∶3, and the patients in model group were divided into pain group( n=40)and non-pain group( n=121)based on their pain scores at 24 h postoperatively. Univariate analysis and binary logistic regression analysis were used to identify the risk factors for postoperative pain in the patients with mixed haemorrhoids, and a column-line diagram prediction model was plotted, the differentiation and consistency of the column-line diagram model were validated using receiver operating characteristic (ROC) curves and calibration curves, and the clinical benefit of the model was evaluated using the decision curve analysis. Results:The results of logistic regression analysis showed that male, preoperative anxiety score≥50, self-efficacy score <80, and external peeling and internal ligation were independent risk factors for postoperative pain in patients with mixed haemorrhoids ( P<0.05). The area under the ROC curve in model group was 0.745, Hosmer-Lemeshow test χ2=1.912, P=0.752; in validation group, the area under the ROC curve was 0.729, Hosmer-Lemeshow test χ2=1.635, P=0.651, and the calibration curve was in good agreement with the actual curve, with good model consistency; the results of the decision curve analysis showed that, when interventions were conducted within the probability range of 0.1 to 0.9 for predicting postoperative pain in patients with mixed hemorrhoids, the clinical benefit was increased. Conclusions:Male, preoperative anxiety score≥50, self-efficacy score <80, and external peeling and internal ligation are independent risk factors for postoperative pain in patients with mixed haemorrhoids, and the column-line graph prediction model of postoperative pain constructed has good differentiation and consistency and high clinical benefit.
