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Effect of environmental mediators on postoperative recovery care after bowel surgery: Regression analysis and
Qiaoling Wu1, Ruipu Li, Shiyang Hou
1Gastrointestinal Rehabilitation Center, Beijing Rehabilitation Hospital Affiliated to Capital Medical University, Beijing, China.
Abstract:
Postoperative recovery care from bowel surgery is essential for patient recovery. Environmental mediators may have a significant impact on the postoperative recovery outcomes, but the specific mechanism is still unclear. This study analyzed National Health and Nutrition Survey 2009-2010 data from 653 participants, collecting demographic, socioeconomic, lifestyle, and environmental exposure data via questionnaires and biospecimens. "Postoperative recovery outcomes" were assessed by combining postoperative complications and functional recovery status. Spearman correlation analysis evaluated associations between environmental mediator exposure and recovery outcomes; multivariate logistic regression assessed independent factor-outcome relationships. A random forest algorithm built a multiclass prediction model, with receiver operating characteristic/area under the curve quantification validating its discriminative performance across nursing conditions. Standardized feature importance analysis evaluated variable contributions to recovery outcomes. Demographic factors such as age, ethnicity, and income level were significantly related to effect of postoperative recovery care. Phthalate metabolites (MEP, monobutyl phthalate [MBP]) were significantly associated with the risk of poor postoperative recovery in environmental media. Multivariate logistic regression analysis indicated that income level and environmental pollutants (MBP, blood lead) were independently associated with postoperative recovery stratification. The random forest model has a good performance in discriminating different nursing conditions, especially in the identification of patients with poor nursing conditions. The importance assessment of independent variables showed that income level, polycyclic aromatic hydrocarbon metabolites and phthalate metabolites were the most important predictors. The study analyzed the effect of environmental mediators on postoperative recovery care after bowel surgery. Demographic factors such as age, ethnicity, and income level were significantly correlated with the postoperative recovery outcomes, the exposure level of environmental mediators such as phthalate metabolites (MEP and MBP) was significantly associated with the risk of poor postoperative recovery, income level and environmental pollutants (MBP, blood lead) were independent factors affecting postoperative care stratification. This study emphasizes the importance of controlling environmental media exposure and optimizing the regulatory mechanism of socioeconomic differences.
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