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在手术后hirschsprung儿童的污染预测的nomogram:一个回顾性研究

Pei Wang¹, Erhu Fang, Xiang Zhao

¹Department of Pediatric Surgery, Tongji Hospital of Tongji Medical College of Huazhong University of Science and Technology; Hubei Clinical Center of Hirschsprung Disease and Allied Disorders, Wuhan, People's Republic of China.

International journal of surgery (London, England)

|December 20, 2023

概括

这项研究开发了一种名谱,用于预测1岁以上的希尔施普朗格病 (HSCR) 患者的术后污垢. 该模型将手术史,肠道长度和手术类型确定为关键风险因素,有助于个性化患者护理.

科学领域:

儿科手术儿科手术
胃肠病学胃肠病学
医疗信息学医疗信息学

背景情况:

赫施普隆病 (HSCR) 是一种需要手术干预的先天性疾病.
手术后污垢是HSCR手术后的常见并发症,影响患者的结果.
需要预测工具来识别患有这种并发症风险较高的患者.

研究的目的:

开发和验证一种名谱,用于预测手术后脏的概率,在接受HSCR手术的1岁以上的患者中.
在这个患者群体中确定术后污染的显著预测因素.

主要方法:

对601名在2000年至2019年间接受手术治疗的HSCR患者 (年龄大于1年) 的回顾性分析.
患者被分为训练 (70%) 和验证 (30%) 组.
最小绝对收缩和选择运算符 (LASSO) 和多变量后勤回归被用来确定名图构造的预测变量.
用C指数,ROC曲线下的面积 (AUC),校准曲线和决策曲线分析来评估模型性能.

主要成果:

分析了31名患者,其中97人经历了手术后的污垢.
污染的关键预测因素包括手术史,切除肠道的长度和特定的手术程序.
诺米图表表现出强大的预测性能,C指数为0.871 (训练) 和0.878 (验证),AUC为0.896 (训练) 和0.866 (验证).
校准曲线表明预测和观察到的污染概率之间有很好的一致性.

结论:

这项研究提供了第一个验证的诺姆图,用于预测1岁以上的HSCR患者的术后污染风险.
开发的模型可以帮助临床医生评估个体污染风险,促进个性化管理策略.
这种工具有可能改善HSCR手术后的患者护理和结果.

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