Construction of a predictive model for postoperative biliary tract infection in patients with obstructive jaundice based on clinical characteristics and biliary drainage methods
10.11816/cn.ni.2025-250434
- VernacularTitle:基于临床特征与胆道引流方式的梗阻性黄疸患者术后胆道感染预测模型构建
- Author:
Ting LIU
1
;
Caidi YING
1
;
Yeyong JIANG
1
Author Information
1. 浙江中医药大学附属宁波市中医院肝胆外科,浙江宁波 315010
- Publication Type:Journal Article
- Keywords:
Patient with obstructive jaundice;
Biliary drainage;
Biliary tract infection;
Risk factor;
Nomo-gram model
- From:
Chinese Journal of Nosocomiology
2025;35(19):2945-2949
- CountryChina
- Language:Chinese
-
Abstract:
OBJECTIVE To investigate the risk factors for biliary tract infection(BTI)after biliary drainage in pa-tients with obstructive jaundice(OJ)based on clinical characteristics and biliary drainage methods,and to con-struct and validate a nomogram model for risk prediction.METHODS A total of 168 patients with OJ treated in the Hepatobiliary Surgery Department of Ningbo Municipal Hospital of TCM from Jan.2020 to Jan.2025 were includ-ed as study subjects.They were divided into a non-infected group(n=97)and an infected group(n=71)based on the occurrence of BTI after biliary drainage.Lasso regression and logistic regression analysis were used to explore the risk factors for BTI after surgery in patients with OJ.The"rms"package in R programming language version 4.2.6 was used to construct the nomogram model,and decision curves,calibration curves and receiver operating characteristic(ROC)curves were plotted to evaluate the model's effectiveness,calibration and discrimination.RESULTS Diabetes history(OR=3.314),drainage method(percutaneous transhepatic cholangial drainage,OR=2.666),preoperative jaundice duration(OR=2.920),alkaline phosphatase(OR=1.064),total bilirubin(OR=1.028),NLR(OR=1.110)and high biliary obstruction(OR=4.770)were identified as risk factors for BTI after surgery in patients with OJ(P＜0.05).The importance of these risk factors,ranked by the feature_importances_function of the logistic regression model,was as follows:high biliary obstruction,drainage method,preoperative jaundice duration,diabetes history,NLR,total bilirubin and alkaline phosphatase.Based on these seven risk fac-tors,a nomogram model for predicting BTI risk after surgery in patients with OJ was constructed.The area under the ROC curve(AUC)of the model was 0.851,with a concordance index of 0.849.The decision curve suggested that the model had good predictive performance within a probability threshold range of 0.050 to 0.920.The calibra-tion curve of the model closely aligned with the ideal curve.CONCLUSIONS The risk factors for BTI after surger-y in patients with OJ include diabetes history,drainage method,preoperative jaundice duration,alkaline phospha-tase,total bilirubin,NLR and high biliary obstruction.The constructed nomogram model for predicting BTI after surgery in patients with OJ demonstrates good predictive performance.
