Risk factors and risk prediction model for mucocutaneous separation in enterostomy patients: A single center experience.

IF 1 4区医学 Q3 MEDICINE, GENERAL & INTERNAL

World Journal of Clinical Cases Pub Date : 2024-11-26 DOI:10.12998/wjcc.v12.i33.6620

Yun Liu, Hong Li, Jin-Jing Wu, Jian-Hong Ye

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引用次数: 0

Abstract

Background: Mucocutaneous separation (MCS) is a common postoperative complication in enterostomy patients, potentially leading to significant morbidity. Early identification of risk factors is crucial for preventing this condition. However, predictive models for MCS remain underdeveloped.

Aim: To construct a risk prediction model for MCS in enterostomy patients and assess its clinical predictive accuracy.

Methods: A total of 492 patients who underwent enterostomy from January 2019 to March 2023 were included in the study. Patients were divided into two groups, the MCS group (n = 110), and the non-MCS (n = 382) based on the occurrence of MCS within the first 3 weeks after surgery. Univariate and multivariate analyses were used to identify the independent predictive factors of MCS and the model constructed. Receiver operating characteristic curve analysis was used to assess the model's performance.

Results: The postoperative MCS incidence rate was 22.4%. Suture dislodgement (P < 0.0001), serum albumin level (P < 0.0001), body mass index (BMI) (P = 0.0006), hemoglobin level (P = 0.0409), intestinal rapture (P = 0.0043), incision infection (P < 0.0001), neoadjuvant therapy (P = 0.0432), stoma site (P = 0.0028) and elevated intra-abdominal pressure (P = 0.0395) were potential predictive factors of MCS. Suture dislodgement [P < 0.0001, OR: 28.0075 95%CI: (11.0901-82.1751)], serum albumin level (P = 0.0008, OR: 0.3504, 95%CI: [0.1902-0.6485]), BMI [P = 0.0045, OR: 2.1361, 95%CI: (1.2660-3.6235)], hemoglobin level [P = 0.0269, OR: 0.5164, 95%CI: (0.2881-0.9324)], intestinal rapture [P = 0.0351, OR: 3.0694, 95%CI: (1.0482-8.5558)], incision infection [P = 0.0179, OR: 0.2885, 95%CI: (0.0950-0.7624)] and neoadjuvant therapy [P = 0.0112, OR: 1.9769, 95%CI: (1.1718-3.3690)] were independent predictive factors and included in the model. The model had an area under the curve of 0.827 and good clinical utility on decision curve analysis.

Conclusion: The mucocutaneous separation prediction model constructed in this study has good predictive performance and can provide a reference for early warning of mucocutaneous separation in enterostomy patients.

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肠造口术患者粘膜分离的风险因素和风险预测模型：单中心经验

背景：粘膜与皮肤分离（MCS）是肠造口术患者常见的术后并发症，可能导致严重的发病率。早期识别风险因素对预防这种情况至关重要。目的：构建肠造口术患者 MCS 风险预测模型，并评估其临床预测准确性：研究共纳入 492 名在 2019 年 1 月至 2023 年 3 月期间接受肠造口术的患者。根据术后 3 周内 MCS 的发生情况，将患者分为两组，MCS 组（n = 110）和非 MCS 组（n = 382）。采用单变量和多变量分析确定 MCS 的独立预测因素并构建模型。受体操作特征曲线分析用于评估模型的性能：结果：术后 MCS 发生率为 22.4%。缝线脱落（P < 0.0001）、血清白蛋白水平（P < 0.0001）、体重指数（BMI）（P = 0.0006）、血红蛋白水平（P = 0.0409）、肠道骤停（P = 0.0043）、切口感染（P < 0.0001）、新辅助治疗（P = 0.0432）、造口部位（P = 0.0028）和腹内压升高（P = 0.0395）是 MCS 的潜在预测因素。缝线脱落 [P < 0.0001, OR: 28.0075 95%CI: (11.0901-82.1751)], 血清白蛋白水平 (P = 0.0008, OR: 0.3504, 95%CI: [0.1902-0.6485]）、体重指数[P = 0.0045，OR：2.1361，95%CI：（1.2660-3.6235）]、血红蛋白水平[P = 0.0269，OR：0.5164，95%CI：（0.2881-0.9324）]、肠套叠[P = 0.0351，OR：3.0694，95%CI：（1.0482-8.5558）]、切口感染[P = 0.0179，OR：0.2885，95%CI：（0.0950-0.7624）]和新辅助治疗[P = 0.0112，OR：1.9769，95%CI：（1.1718-3.3690）]是独立的预测因素，并被纳入模型中。该模型的曲线下面积为 0.827，在决策曲线分析中具有良好的临床实用性：本研究构建的粘膜分离预测模型具有良好的预测性能，可为肠造口患者粘膜分离的早期预警提供参考。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

World Journal of Clinical Cases Medicine-General Medicine

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3384

期刊介绍： The World Journal of Clinical Cases (WJCC) is a high-quality, peer reviewed, open-access journal. The primary task of WJCC is to rapidly publish high-quality original articles, reviews, editorials, and case reports in the field of clinical cases. In order to promote productive academic communication, the peer review process for the WJCC is transparent; to this end, all published manuscripts are accompanied by the anonymized reviewers’ comments as well as the authors’ responses. The primary aims of the WJCC are to improve diagnostic, therapeutic and preventive modalities and the skills of clinicians and to guide clinical practice in clinical cases.