Prediction model and web-based risk calculator for postoperative ileus after loop ileostomy closure.

Area of Science:

• Gastroenterology
• Surgical Outcomes
• Predictive Modeling

Background:

• Postoperative ileus (POI) is a frequent and impactful complication following loop ileostomy closure.
• Accurate prediction of POI is crucial for patient management and resource allocation.

Purpose of the Study:

• To develop and externally validate a prediction model for postoperative ileus (POI) after loop ileostomy closure.
• Identify key predictors of POI to aid clinical decision-making.

Main Methods:

• The study adhered to the TRIPOD checklist for model development and validation.
• A logistic regression model was developed using data from 531 patients undergoing loop ileostomy closure.
• External validation was performed on an independent cohort of 216 patients.

Main Results:

• The final prediction model incorporated five variables: age, ASA fitness grade, underlying pathology/treatment, interval between ileostomy creation and closure, and surgery duration.
• The model demonstrated good discrimination (AUC 0.68 in development, 0.72 in validation) and calibration in both cohorts.
• POI incidence was 16.8% in the development cohort and 15.7% in the validation cohort.

Conclusions:

• A robust, five-variable prediction model for POI after loop ileostomy closure was successfully developed and validated.
• The model shows good performance and can be utilized to predict POI risk in clinical practice.