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Risk Prediction Model of Peristomal Skin Complications Among Patients with Colorectal Cancer and an Ostomy: A
Li-Li Ma1, Ya-Juan Zhang, Hui-Ren Zhuang
1Li-li Ma, MSc, RN, is PhD Candidate, Medical College, Tongji University, Shanghai, Chinaï¼Department of Nursing, Shanghai East Hospital, School of Medicine, Tongji University, Shanghai, China. Ya-juan Zhang, MSc, RN, is Head Nurse, Department of Nursing, Shanghai Sixth People's Hospital, School of Medicine, Jiao Tong University, Shanghai. Hui-ren Zhuang, MSc, RN, is Department Head Nursing, Department of Nursing, Shanghai East Hospital, School of Medicine, Tongji University. Hui Jiang, PhD, RN, is Nursing Director, Department of Nursing, Shanghai First Maternity and Infant Hospital, School of Medicine, Tongji University. Acknowledgments: The authors express their gratitude to all the participants who were involved in this study. The authors have disclosed no financial relationships related to this article. Submitted November 14, 2023; accepted in revised form January 23, 2024.
Objective:
To analyze the risk factors for peristomal skin complications (PSCs) in patients with colorectal cancer and an ostomy, construct a prediction model, and verify its effectiveness.
Methods:
In this cross-sectional study, researchers recruited 265 patients with an ostomy at the stoma clinic of a tertiary hospital, from May 2022 to August 2023. Patients were divided into two groups: complications group (n = 81) and no complications group (n = 184). Researchers constructed a logistic regression prediction model using univariate and multivariate analyses. From May 2023 to August 2023, a validation group of 135 patients with an ostomy was selected for external validation of the model.
Results:
The incidence of PSCs was 30.57% in the modeling group and 30.37% in the validation group. The predictor variables were preoperative and postoperative health education, tumor therapy within 3 months, preoperative stoma positioning, stoma height, stoma type, and excrement state. The Hosmer-Lemeshow test yielded a P value of .513, the area under the receiver operating characteristic curve was 0.872, the Youden index was 0.561, and the sensitivity and specificity were 0.827 and 0.734. For external validation, the Hosmer-Lemeshow test yielded a P value of .835, the area under the receiver operating characteristic curve was 0.887, and the sensitivity and specificity were 0.905 and 0.720, respectively.
Conclusions:
The prediction model demonstrates good predictive efficacy and can serve as a reference for clinical caregivers in identifying patients at high risk of PSCs.
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