开发和验证一个名ogram模型来预测杀性肠道阻塞的风险
Yanjing Zhu1, Qiangqiang Wang1, Lvhao Cao1
1Department of Emergency Surgery, the First Affiliated Hospital of Anhui Medical University, Hefei, Anhui, PR China.
Scientific reports
|December 28, 2024
概括
一个新的诺莫格拉姆模型准确地区分了简单的与窒息性肠道阻塞,使用中性粒细胞百分比,腹膜刺激,腹液和白蛋白. 这种工具有助于临床医生识别患有杀性肠道阻塞高风险的患者.
科学领域:
- 胃肠病学和肝病学
- 手术瘤学手术瘤学
- 医学诊断 医学诊断 医学诊断
背景情况:
- 肠道阻塞是一种常见的手术紧急情况.
- 区分简单和窒息性阻塞对于及时干预和改善患者结果至关重要.
- 当前的诊断方法在准确预测窒息的能力上可能受到限制.
研究的目的:
- 开发和验证一个名目录预测模型,以区分简单肠道阻塞和喉肠道阻塞.
- 为了确定杀性肠道阻塞的独立风险和保护因素.
- 为肠道阻塞患者提供临床决策的客观工具.
主要方法:
- 对560名肠道阻塞患者的临床数据进行了回顾性分析.
- 多变量后勤回归用于识别独立的风险和保护因素.
- 使用培训 (n=393) 和验证 (n=167) 队列构建和验证一个名ogram模型.
- 使用ROC曲线 (AUC),C指数,Hosmer-Lemeshow测试,校准曲线和决策曲线分析 (DCA) 评估模型性能.
主要成果:
- 中性粒细胞百分比,腹膜刺激征兆和腹液被确定为杀性肠道阻塞的独立危险因素.
- 专被确定为一种独立的保护因子.
- 该名录显示了高的区分能力,AUC为0.842 (训练) 和0.839 (验证).
- 该模型显示了良好的校准和临床效用,由C指数,Hosmer-Lemeshow测试,校准曲线和DCA证实.
结论:
- 开发的诺米图谱是一种有希望的,方便的工具,用于评估杀性肠道阻塞的风险.
- 这个模型可以帮助临床医生选高风险人群,并指导临床决策.
- 诺米图表提供的客观证据可以改善肠道阻塞的管理.
相关概念视频
01:29Intestinal Obstruction I: Introduction
51
Intestinal obstruction is a partial or complete blockage of the small or large intestine that disrupts the normal flow of intestinal contents through the lumen. This interruption impairs digestion, absorption, and fluid balance, and may lead to serious complications if not treated promptly.Mechanical ObstructionMechanical obstruction occurs when a physical blockage prevents intestinal contents from passing, arising from within the lumen or the bowel wall, or from external compression.Adhesions,...
51
01:07Intestinal Obstruction II: Pathophysiology
47
Intestinal obstruction triggers a series of physiological responses, starting with gas and fluid accumulation in the bowel segment proximal to the obstruction, leading to distension. This distended intestine compresses the diaphragm, hindering lung expansion and potentially leading to reduced respiratory effort, atelectasis, and pneumonia.To overcome the blockage, the gut intensifies contractions, causing colicky abdominal pain, nausea, and vomiting, which reduces fluid and food intake and...
47